Gender as an Obstacle in HIV/AIDS Prevention: Considerations for the Development of HIV/AIDS Prevention Efforts for Male-to-Female Transgenders

SUMMARY

Social discourses regarding gender are responsible for molding people's cognitions, perceptions, behaviors, and interactions with others. Approaching and understanding gender socialization is an important strategy that must be included in the development of HIV/AIDS prevention intervention efforts targeting male-to-female (MTF) transgender people.

This paper represents an effort to identify the influence of gender construction among a group of MTF transgenders in Puerto Rico. Using combined methodology, authors examined results from a questionnaire and in-depth interviews with a convenience sample of MTF transgenders living in the San Juan metropolitan area.

Quantitative analysis demonstrated that this sample is composed of young, unemployed, and undereducated population. Many participated in the sex industry. Participants reported need for basic health and social services and alienation from social networks. Qualitative analysis confirmed their traditional social construction of the “feminine.” Their discourse underlines their need to reinforce their identity by the construction of a female self which undermines their possibilities for negotiating safer sex, as happens to most females in Latino societies.

Social vulnerability, institutional exclusion, and gender construction issues are obstacles for the HIV prevention efforts among these communities.     

Brief Report: Power and Attitudes in Relationships (PAIR) Among a Sample of Low-Income,African-American Women: Implications for HIV/AIDS Prevention

This study describes a scale that was designed to measure low-income urban, heterosexual women's perception of Power and Attitudes in Relationships (PAIR). Although frequently mentioned in the literature as an important aspect of women's risk for HIV, there are few described scales which measure such attitudes among this population. PAIR was based in part on Connell's (1987) Theory of gender and power. PAIR was found to be reliable (alpha = 0.79) among a Baltimore cross-sectional sample of inner-city women (n = 417), half of whom were HIV-negative and half were HIV-positive. Our findings suggest that PAIR is reliable among both HIV-infected and HIV-uninfected inner-city women. The scale can be a useful tool in understanding the interpersonal context of women's risk of HIV.     

Subverting Culture: Promoting HIV/AIDS Prevention Among Puerto Rican and Dominican Women

This article discusses the challenges faced by researchers and interventionists when attempting to promote change in social norms and normative beliefs that promote HIV/AIDS risk-related behaviors among Puerto Rican and Dominican women. The article focuses on the role of culture in HIV/AIDS prevention with women by analyzing the sociohistorical context of some cultural beliefs and by illustrating the tension between risk-related and protective cultural beliefs in research conducted by the authors with women in both New York and Puerto Rico. The authors propose that promoting changes in sex-related social norms and normative beliefs might be constructed as a subversive act and present the challenge this analysis poses for community psychology. They conclude that this conceptualization might be construed as subversive because rather than idealizing culture, it promotes changes that respect diversity within the culture and foster participation in the development of new cultural values, beliefs and norms.     

Reasons and Justifications for Considering Pregnancy Among Women Living with HIV/AIDS

Despite the risks associated with pregnancy, available data suggest that HIV-infected women are no less likely to become pregnant than uninfected women. To understand HIV-infected women's reasons for wanting to have a child, focused interviews were conducted with a predominantly minority sample of 51 HIV-infected women in New York City. They were noted to actively weigh both the potential risks and benefits of their pregnancy decisions. Women reported three major reasons for wanting a child: (1) her husband/boyfriend really wants children, (2) having missed out on raising her other children, and (3) believing that a child would make her feel complete, fulfilled, and happy. Women also reported several justifications which they believed offset the risks of pregnancy, including: (1) other HIV-infected women were having healthy babies, (2) feeling optimistic about having a healthy baby due to the prophylactic effects of AZT (zidovudine), (3) having faith that God will protect the child, (4) being young and "healthy" will prevent transmission, and (5) feeling that she is better able to raise a child now. These findings suggest that to make fully informed pregnancy decisions, women should be encouraged to explore their reasons for wanting pregnancy, as well as discuss the potential risks.     

An Evaluation of an HIV/AIDS Prevention Program in a Nigerian Setting

The study examined the success of a group based behavioural intervention with Nigerian youths aimed at reducing the risk of contracting and spreading HIV/AIDS and other sexually transmitted illness (STI). Participants were 147 youths (males=75, females=72, age range 5 to 24 years). The study explored the influence of motivational factors (self efficacy), attitudinal factors (perceived personal risk), knowledge (instrumental knowledge of AIDS) and behavioural factors (refusal of high-risk behaviour) in predicting condom use amongst youth participating in a group-based HIV prevention intervention. Findings indicated that the intervention program reliably predicted participants' attitudinal dispositions to high risk heterosexual behaviour. Instrumental knowledge of HIV/AIDS, perceived self-efficacy, perceived personal risk of HIV/AIDS and refusal of risk behaviour were significant predictors of condom use.     

Perceived Church-Based Needs and Assets for HIV/AIDS Prevention in an Urban Nigerian Community

Health intervention programs have the potential to use church-based assets to address a wide range of health issues. This study examined the assets Nigerian church members believed their churches needed, including the assets they thought they had to engage in HIV/AIDS prevention activities. Eight hundred and thirty members from 83 churches completed a questionnaire designed from forum focus group data. Respondents were males and females aged 18 years old and above, with primary, secondary, university, or vocational education, and were more likely to be married than single (never married), separated, divorced, widowed or remarried. The data revealed that church members needed access to health promotion assets, including the expertise of members who are health professionals to engage in HIV/AIDS prevention activities. We recommend an intensive HIV/AIDS prevention reorientation-training workshop for church leaders to ensure a sustainable plan to address HIV/AIDS prevention needs.     

Effects of HIV/AIDS Information on Attitudes Toward AIDS: A Cross-Ethnic Comparison of College Students

College students (N = 274) from five ethnic groups were administered an AIDS information questionnaire and the Attitudes Toward AIDS Scale (ATAS; Goh, in press) to determine the effects of AIDS information on attitudes toward AIDS. A series of chi-squares and multivariate analyses of variance indicated significant differences among ethnic groups on the usage of HIV/AIDS information, the self-reported degree of knowledge about HIV/AIDS, measured knowledge about HIV/AIDS, and HIV/AIDS-related attitudes. Besides ethnicity, access to HIV/AIDS information and self-reported degree of knowledge about AIDS had significant effects on a person's measured knowledge of and attitudes toward HIV/AIDS.     

艾滋病防治领域关键社会资本要素探讨

尽管已经成为一个学术研究热点.社会资本作为一种无形的资本形式.目前对其包括的核心要素仍没有达成共识.通过大量相关理论文献复习,尝试性地总结该理论在艾滋病防治中的关键要素,包括社会关系网络、信任、合作、宗教信仰、杜区建设以及非政府组织等.为今后在艾滋病防治领城应用社会资本理论提供基础和借鉴.     

Disengagement and Engagement Coping with HIV/AIDS Stigma and Psychological Well-Being of People with HIV/AIDS

The stigma associated with HIV/AIDS poses a psychological challenge to people living with HIV/AIDS. We hypothesized that that the consequences of stigma-related stressors on psychological well-being would depend on how people cope with the stress of HIV/AIDS stigma. Two hundred participants with HIV/AIDS completed a self-report measure of enacted stigma and felt stigma, a measure of how they coped with HIV/AIDS stigma, and measures of depression and anxiety, and self-esteem. In general, increases in felt stigma (concerns with public attitudes, negative self-image, and disclosure concerns) coupled with how participants reported coping with stigma (by disengaging from or engaging with the stigma stressor) predicted self-reported depression, anxiety, and self-esteem. Increases in felt stigma were associated with increases in anxiety and depression among participants who reported relatively high levels of disengagement coping compared to participants who reported relatively low levels of disengagement coping. Increases in felt stigma were associated with decreased self-esteem, but this association was attenuated among participants who reported relatively high levels of engagement control coping. The data also suggested a trend that increases in enacted stigma predicted increases in anxiety, but not depression, among participants who reported using more disengagement coping. Mental health professionals working with people who are HIV positive should consider how their clients cope with HIV/AIDS stigma and consider tailoring current therapies to address the relationship between stigma, coping, and psychological well-being.     

Sex-Related HIV/AIDS Prevention Among African American College Students: Issues for Preventive Counseling

This study examined condom use during oral and anal sex among 1,593 African American male and female college undergraduates. Findings suggest a high level of concordance between men and women on several measures. However, female participants were more likely to use condoms during oral and anal sex than were male participants.     

对建立我国艾滋病防治督导与评估体系的思考

随着我国艾滋病防治工作的持续深入,定期对艾滋病防治工作进行督导与评估越来越重要.但是,到目前为止,我国尚未建立国家综合协调的艾滋病防治督导与评估体系.通过对建立国家艾滋病防治督导评估体系的必要性、可行性及存在的问题进行分析,围绕如何构建一个统一、综合、有效的督导评估体系提出政策建议.     

对建立我国艾滋病防治督导与评估体系的思考

随着我国艾滋病防治工作的持续深入,定期对艾滋病防治工作进行督导与评估越来越重要。但是,到目前为止,我国尚未建立国家综合协调的艾滋病防治督导与评估体系。通过对建立国家艾滋病防治督导评估体系的必要性、可行性及存在的问题进行分析,围绕如何构建一个统一、综合、有效的督导评估体系提出政策建议。     

ACHIEVEMENT STYLES OF WOMEN LEADERS AND THEIR PEERS: Toward an Understanding of Women and Leadership

Women's achievement was examined by studying the achievement styles and leadership outcomes of women college leaders as compared with those of a control sample of undergraduate men and women (Study 1) and with those of men college leaders (Study 2). Women leaders scored significantly higher than control women on six of nine achievement styles, scored higher than control men on three of nine, and derived satisfaction from a greater number of achievement sources than did women or men controls. Women leaders perceived more support from their institutions and attached more importance to contributing to their community and becoming an authority in their field than did men or women controls. Achievement style was related to leadership role, with endorsement of six styles correlated with attaining leadership. Achievement profiles of women leaders were replicated in Study 2. Men and women college leaders showed similar profiles on eight of nine achievement styles. However, women leaders were significantly less likely to derive satisfaction from competitive achievement than were men leaders.     

An Investigation of the Determinants of Stigmatization and Prejudice Toward People Living With HIV/AIDS

The components and determinants of HIV/AIDS stigma and prejudice were investigated in an online‐questionnaire study. The results show that the components of the attitude toward people with HIV/AIDS consist of social distance, demands for political measures, negative stereotypes, and attribution of responsibility to people living with HIV/AIDS. Besides antigay attitudes and false beliefs about ways of infection, the HIV/AIDS attitude is connected to and depends on social dominance orientation (SDO) and right‐wing authoritarianism (RWA). Structural equation modeling indicated that antigay attitudes and false beliefs function as mediator variables for SDO and RWA. Implications of the results are discussed.     

Attitudes Toward People Living With HIV/AIDS: A Model of Attitudes to Illness1

This study examined attitudes toward people living with HIV/AIDS within a sample of 220 young men and women. As predicted, a multiple regression analysis revealed that the fear of contracting HIV/AIDS through casual contact was a significant predictor of both men's and women's willingness to interact with people living with HIV/AIDS. Attitudes toward homosexuality were also a significant predictor of attitudes toward people living with HIV/AIDS among women, who generally have a low risk of contracting the disease in Western societies. These results indicate that attitudes toward people with a serious illness may be strongly related to the perceived risk of contracting the disease.     

HIV/STD Risk Factors for Women with Violent Male Partners

This study compared 167 women, categorized as nonabused, emotionally abused, or physically abused in their primary relationships, on sexual risk factors. Physically abused women differed in several ways: greater STD risk, psychosocial distress, and substance use; more traditional gender role beliefs; lower self-esteem; more likely to have been raped and to engage in sex for pay; and less likely to attend the project's STD/HIV risk reduction groups. Within primary relationships, they differed in amount of decision-making power about safer sex, likelihood of nonmonogamy, use of substances before sex, and self-efficacy about initiating condom use. African American women reported higher rates of emotional abuse than White women, a finding related mainly to their lower socioeconomic status in this sample.     

Psychometric properties of the Death Anxiety Scale (DAS) among HIV/AIDS patients

AIDS patients and HIV carriers who are aware of their condition are under multiple kinds of stress with adverse effects on their emotional state and personal and social activity. This paper reports the psychometric properties of the DAS (Death Anxiety Scale) using the Spanish version in the clinical setting. The sample is made up of 148 HIV/AIDS patients (109 men and 39 women). The internal consistency of the scale was .72 and its test-retest reliability was .70. Principal components analysis extracted five factors that jointly accounted for 56.5% of the total variance. As, on the whole, these results are very similar to those reported by other authors, it is concluded that the Spanish DAS is a valid instrument for the assessment of death anxiety in Spanish HIV/AIDS patients.