Assessing the Effectiveness of a Trauma-Oriented Approach to Treating Prostituted Women in a Prison and a Community Exiting Program

Women who have been prostitutes are social work clients in many clinical, correctional, and community settings. Unique programming that addresses the high levels of trauma symptoms reported by prostituted women has yet to be explored. The purpose of this study is to explore the effectiveness of a group trauma and abuse intervention for prostituted women from two settings, prison and a community exiting program. A quasi-experimental research design was used. Twenty-nine women participated in a 12-week psychoeducational trauma and abuse intervention program called Esuba. All participants reported decreases in trauma symptoms, but the prison group showed a greater number of significant changes in trauma symptomology than the community group. Implications for practice and future research implications are discussed.     

Evidence for a Comprehensive Sexuality Education Intervention that Enhances Chinese Adolescents’ Sexual Knowledge and Gender Awareness and Empowers Young Women

While Chinese adolescents become more sexually active, their sexual attitudes are profoundly influenced by traditional gender and sexual norms. The tensions between the rapid transition in youth sexuality and lags in sex education call for a paradigm shift of sexuality education in China. The present study examined the effectiveness of a school-based empowerment comprehensive sexuality education (CSE) intervention in changing adolescents’ sexual knowledge, gender and sexual attitudes, and sexual self-efficacy. We used data from a quasi-experimental intervention study with self-administered pretest and posttest surveys conducted among 1131 10th grade high school students in Lanzhou, northwest China. Whereas 583 participants in two intervention schools attended 12 45-min CSE sessions focusing on gender, rights, and critical thinking skills across 4–7 months, 548 participants in two comparison schools received no or limited conventional sex education. After controlling for differences in sociodemographics and in the influence of family, peers, and internet use between the two groups, female and male adolescents exhibited significantly more accurate sexual knowledge, stronger endorsement of nontraditional gender roles, and greater rejection of sexual double standards immediately after the intervention. Additionally, young women reported significantly higher sexual self-efficacy following the intervention. The findings suggest that the school-based empowerment CSE intervention is helpful in creating an environment in which both young men and young women benefit in sexual knowledge and gender awareness and young women increase their sexual decision-making skills, thereby lending support to the theory and practice of an empowerment CSE approach.

     

Consequences of Child and Adult Sexual and Physical Trauma among Deaf Adults

The purpose of this study was to evaluate the consequences of sexual and physical trauma among a sample of deaf adults. Thirty-two men and 45 women completed the Life Event Checklist (LEC), the Clinician Administered PTSD Scale (CAPS), the Trauma Symptom Inventory (TSI), the Somatoform Dissociation Questionnaire–20 (SDQ–20) and a sociodemographic questionnaire. In this sample, 40.6% of the male participants and 53.3% of the female participants had experienced some type of sexual trauma during their lifetimes. Physical trauma was reported by 75% of males and 71.1% of female participants. For those who had experienced childhood sexual trauma, the odds ratio of revictimization in adulthood was 6.69. Sexual trauma also rarely occurred by itself. Two thirds of all participants with sexual trauma histories also reported some type of physical abuse. Participants with sexual trauma histories displayed significantly more symptoms of PTSD and depression than people without such trauma history. Physical and sexual abuse represent significant problems in the deaf community. The authors include a call for the development of targeted intervention attempts to prevent further victimization in deaf child and adolescent populations.     

The relationship between childhood sexual abuse and sexual health practices of homeless adolescents

This study explored the gender differences in sexual self-concept, personal resources for sexual health, safe sex behaviors, and risky sexual behaviors among homeless adolescents with and without histories of sexual abuse. Data for this secondary analysis were collected in 2003 to 2004 in the first phase of a larger repeated-measures sexual health intervention study; 371 homeless youth between 16 and 23 years of age (M = 19.26, SD = 1.83) were recruited from a street outreach center. The majority (64.6%) of participants were males. Self-report instruments were completed at the outreach center via audio computer-assisted self-interview (A-CASI) format. It was found that female participants were better off than males on numerous measures of sexual health behaviors and attitudes. Sexually abused participants had significantly less future time perspective (p = .05), fewer sexual self-care behaviors (p = .04), and less social support than nonabused participants (p = .01) and almost significantly more sexual risk-taking (p = .08). However, no significant differences were found between abused and nonabused participants on sexual self-concept, self-efficacy or intention to use condoms, safe sex behaviors, AIDS knowledge, assertive communication, or self-efficacy to perform testicular/ breast self-exams. Overall, participants who did not report a history of sexual abuse had significantly more sexual health resources and engaged in fewer sex-risk behaviors than those who reported having been abused. These differences have notable implications for screening adolescents for a history of sexual abuse. Adolescents who report sexual abuse should receive risk counseling and be screened regularly for the development of sexual risk behaviors.     

A music-based HIV prevention intervention for urban adolescents

OBJECTIVE: This research examines the process of conducting and evaluating a music-based HIV prevention intervention among urban adolescents, and is informed by the information, motivation, behavioral skills (IMB) model. DESIGN: Musically talented opinion leaders were recruited to write, record, and distribute HIV prevention themed music to their peers to increase HIV prevention motivation, behavioral skills, and behaviors. In this 3-month field experiment, participants were 306 students enrolled in health classes at each of three large multiracial urban high schools (one treatment school; two control schools). MAIN OUTCOME MEASURES: Measures of HIV prevention information, motivation, behavioral skills, and behaviors, both pre- and postintervention. RESULTS AND CONCLUSION: Results indicate that the intervention influenced several aspects of HIV prevention motivation, behavioral skills, and condom use and HIV testing behaviors. This research demonstrates that the incorporation of music into HIV prevention interventions for adolescents has the potential to be effective.     

Treatment of a four-year-old victim of incest

Abstract

A case study describing the use of behavior techniques in the treatment of a four—year—old sexual assault victim is presented. The target behaviors included eating, phobic behaviors, self—injurious behaviors, and comments made about the father (the perpetrator) and the paternal grandmother. The child's mother served as both data collector and therapist. The study demonstrates that child victims can experience a sexual assault trauma syndrome similar to that manifested by adult victims. Additionally, the findings illustrate that a simple behavioral intervention implemented by a parent can be effective in treating young sexual assault victims.     

保护动机对农村流动人口性病艾滋病高危性行为的预测

农村流动人口已经成为我国性病艾滋病预防干预的重点人群。为了探讨流动人口所存在的性病艾滋病高危性行为,以及保护动机（Protection Motivation）对性病艾滋病高危性行为的预测作用,研究选取2201名从农村到北京打工已有3个月的流动人口为被试,采用问卷调查的形式,要求其报自己报告初始性行为发生的时间、性伙伴的数量、商业性行为、性伙伴的性行为、安全套的使用,对我国性病艾滋病严重程度的评估,以及所拥有的性病艾滋病症状知识和传播知识。对904名已发生性行为的流动人口的统计分析发现：（1）农村流动人口存在较多的高危性行为,男性流动人口的高危性行为明显多于女性流动人口;（2）保护动机理论对农村流动人口的性病艾滋病高危性行为具有明显的预测作用,其中的外在奖励、内在奖励、反应效能和反应代价与农村流动人口的性病艾滋病高危性行为的关系更为密切。研究揭示,保护动机理论可以作为我国今后开展农村流动人口性病艾滋病高危性行为预防干预工作的一个基础     

Inconsistent Condom Use and History of Trauma Among Vietnamese Female Sex Workers in a Chinese Border Region

Previous studies have indicated a potential association between trauma, such as physical violence, emotional violence and sexual violence, and high-risk sexual behavior. Female sex workers (FSWs) were interviewed to elicit history of traumatic events and sexual behaviors. Among 187 participants, 79 (42.2 %) inconsistently used condoms with clients in the past 30 days. Experiencing community violence (OR: 0.4; 95 % CI: 0.2, 0.8) was found to be significantly protective for inconsistent condom use. In this study, experiencing community violence was found to be protective for inconsistent condom use among FSWs, but none of the other trauma subgroups had significant associations with inconsistent condom use. Reasons for unprotected sex among FSW may be more related to economic or other contextual factors.     

The impact of rape on women's sexual health risk behaviors.

This study used cluster analysis to identify three patterns of sexual health risk behaviors in a sample of adult rape survivors (N=102). Women in the 1st cluster (high risk) reported substantial increases from pre- to postrape in their frequency of sexual activity, number of sexual partners, infrequency of condom use, and frequency of using alcohol and/or drugs during sex. The 2nd cluster (moderate risk) reported increases in frequency of sexual activity and number of partners but mitigated that risk with increased condom use. Survivors in the 3rd cluster (low risk) indicated that their sexual health behaviors had become much less risky postrape. An ecological model predicting cluster membership revealed that individual-level and contextual factors predict patterns of risk behaviors.     

Centrality of Religiosity of Relationships for Affectionate and Sexual Behaviors Among Emerging Adults

Emerging adults’ religiosity has been consistently linked with less participation in sexual behaviors as supported by cognitive dissonance theory. However, this association may be different when examining centrality of religiosity of relationships (CRR), meaning participating in and discussing religiosity and spirituality with a current or anticipated romantic partner. The goal of this study is to examine the influence of CRR for emerging adults’ affectionate and sexual behaviors. Additionally, we test if the association between CRR and affectionate and sexual behaviors varies by gender, given males’ more positive attitudes towards sexual behaviors compared to females. Data for this study comes from 284 emerging adults, ages 18 to 29 (mean age = 20.9 years; 70.1% female) from an area in the Midwestern United States. Results illustrated that CRR is negatively associated with affectionate behaviors, intimate touching behaviors, oral sex behaviors, and sexual (vaginal) intercourse. Additionally, gender significantly moderated these relationships. Male participants reporting low levels of CRR conveyed significantly higher participation with these sexual behaviors compared to males reporting high levels of CRR, whereas CRR did not appear to significantly alter female participants’ engagement with these sexual behaviors. These findings provide some evidence that CRR contributes to males’ romantic development and that CRR may increase intimacy in females’ romantic relationships, which could promote sexual activity. Other implications for religious and sexual development are discussed.     

AUTOMATIC RELATIONSHIP–HARM ASSOCIATIONS AND INTERPERSONAL TRAUMA INVOLVING CLOSE OTHERS

Women exposed to violence early in life are at risk of revictimization. The interpersonal schema hypothesis of revictimization proposes that revictimized women will be more likely to hold negative expectations about intimate relationships, including expectations that relationships involve harm, relative to singly or nonvictimized women. To test the interpersonal schema hypothesis, we used the implicit lexical decision task to examine automatic associations between relationship and harm concepts among college women who reported histories of no, single, or multiple types of interpersonal trauma involving close others (e.g., family member, partner). Women exposed to multiple types of interpersonal trauma involving close others showed stronger relationship–harm associations than singly or nonexposed women. Relationship–harm associations predicted the number of interpersonal trauma types (e.g., sexual, physical trauma) involving close others reported by participants, but were unrelated to posttraumatic stress disorder (PTSD) symptoms. Findings suggest that relational schemata held by women exposed to multiple types of interpersonal trauma involving close others include concepts of harm, which may have implications for how multiply victimized women behave in and think about intimate relationships.     

Measuring the Dimensions of Women's Sexuality: The Women's Sexual Self-Concept Scale

The sexual self-concept is an important component of the self-concept that researchers have rarely examined. The Women's Sexual Self-Concept Scale (WSSCS) is a 39-item measure designed to assess women's sexual self-concept. Women rate the extent to which various behaviors, cognitions, emotions, and adjectives describe their sexuality. In a study with 262 women, the measure was found to be both reliable and valid. Three factors were identified through exploratory Principal Components Analysis. Women rated themselves highest on the Reserved Approach subscale, followed by the Agentic Sexuality subscale, and the Negative Associations subscale. Compared to a stereotype of women's sexuality (obtained with a mixed-gender group of 444 participants), the women in the present study rated themselves higher on the Reserved Approach subscale and lower on the Negative Associations subscale. Group differences in women's sexual self-concepts were identified by past xinvolvement in romantic or sexual relationships, and current sexual involvement.     

Socially Optimized Learning in a Virtual Environment: Reducing Risky Sexual Behavior Among Men Who Have Sex With Men

A socially optimized learning approach, which integrates diverse theoretical perspectives, places men who have sex with men (MSM) in an interactive virtual environment designed to simulate the emotional, interpersonal, and contextual narrative of an actual sexual encounter while challenging and changing MSM's more automatic patterns of risky responses. MSM assume a character's identity and are scaffolded in their decision‐making and relearning process by supportive, and often humorous, peer coaches who encourage situated learning of self‐regulatory and behavioral skills, and tailor and frame their responses to be responsive to the men's behavioral choices. In a longitudinal design, participants were randomly assigned to receive either an interactive video (IAV) intervention with peer counseling or to a peer‐counseling‐alone control. Compared to the counseling alone, men who also received the IAV reduced risky anal sex behaviors and increased protected anal sex behaviors.     

PERCEPTIONS OF SEXUAL HARASSMENT

Two hundred eight faculty members and 314 graduate students located at a West Coast university were presented with 24 brief situations describing five types of sexual harassment in a university setting: gender harassment, seductive behavior, sexual bribery, sexual coercion, and sexual imposition or assault. The participants were randomly assigned to rate the situations under one of four instructional conditions that described combinations of the level of the student and authority of the faculty portrayed in the brief vignettes. Women were more likely than neither the target student's level (i.e., graduate or undergraduate) nor the degree of the faculty member's power over her affected the participants' ratings of the situations. The results indicated that, with the exception of the more coercive and intrusive behaviors, considerable uncertainty may still exist about what constitutes sexual harassment within the university setting.     

Sexual Fantasy,Masturbation and Pornography Among Egyptians

Sexual behavior is subjected to varying degrees of social, cultural, religious and moral constraints. With the lack of Egyptian studies addressing the prevalence of sexual fantasy, masturbation and pornography consumption, the aim of this study was to assess the prevalence of these behaviors among Egyptians, and its relation to socio-demographic characteristics. A cross-sectional study was carried out on 1532 patients who attended four outpatient clinics of Menoufia University Hospital in the time from January to March 2015. A significant higher prevalence of sexual fantasy was found among female participants, whereas unmarried males showed a higher prevalence compared to married ones. The prevalence of masturbation and pornography was significantly higher among males and among participants with higher educational level. Higher masturbation and pornography prevalence was found among married males with a marriage duration of >10–20 years, where a higher prevalence was found among married females with a marriage duration of ≤10 years. The study showed a considerably high prevalence of sexual fantasy, masturbation and pornography among the participants. Future studies are needed to assess the risk factors that contribute to this high prevalence. This should be followed by a comprehensive and effective intervention program to ensure optimum reproductive and sexual health among Egyptians.     

Men as Allies: The Efficacy of a High School Rape Prevention Intervention

This study investigated the effects of a Men as Allies‐based intervention on high school students' rape‐supportive attitudes and behaviors. As hypothesized at posttest, the male and female experimental groups demonstrated a significant decrease in rape‐supportive attitudes, which was maintained at follow‐up. Male participants viewed peers' attitudes toward sexual violence as significantly different (worse) from peers' pretest self‐ratings; after intervention, male and female experimental group participants' peer ratings were significantly more accurate.     

Relationship between Trauma and Risky Behavior in Substance-Abusing Parents Involved in a Family Dependency Treatment Court

This exploratory study examined participants in a Family Dependency Treatment Court (FDTC), designed for substance-abusing parents whose children were removed from the home. Twenty-five participants were interviewed one year after FDTC enrollment to assess retrospectively the relationship between trauma history and risky behaviors. Treatment compliance rates were found to be high, and most participants had negative urinalysis results. Qualitative analyses revealed that approximately half of the participants attributed decreases in risky behaviors to the FDTC program. This study increases understanding of the effect of substance abuse and trauma on high-risk behaviors and might help to improve services for substance-abusing parents involved in the child welfare system. Finally, the future success of reducing child abuse and neglect and parental substance use could hinge on the partnership between judicial and substance abuse treatment through FDTCs. Findings from this exploratory pilot study should be replicated with more representative and larger samples.     

Evaluating a novel intervention to reduce trauma symptoms and sexual risk taking: qualitative exit interviews with sexual minority men with childhood sexual abuse

Childhood sexual abuse (CSA) continues to affect sexual minority men (SMM) at disproportionate levels and contributes to multiple negative health outcomes, including sexual-risk taking and HIV acquisition. This paper presents qualitative evaluative feedback from SMM (N = 9) who participated in a 10-session Cognitive Behavioral Therapy-Trauma and Sexual Health (CBT-TSH) intervention to reduce CSA-related posttraumatic stress reaction and distress. The treatment was designed to increase accurate sexual risk appraisals and to improve self-care health behaviors related to HIV/STI acquisition. The researchers identified four emerging themes: (1) motivation to participate, (2) response to cognitive therapy, (3) process of change, and (4) considerations for intervention improvement. These qualitative findings provide useful feedback on the acceptability of an innovative program that integrates CBT for trauma related to CSA with sexual risk-reduction counseling.