HIV/AIDS prevention support resourcing with family and peers: University student perspectives

This study explored how students construct family and peers as resources for their HIV prevention. The participants were 20 education students from a South African technology education university (female = 60%, black = 85%; age range = 18 to 24). They completed a semi-structured interview on their access to family and peers talking about HIV/AIDS prevention in the context of perceived cultural influences. The data was thematically analysed using open-coding. Findings suggest that students shared information about HIV/AIDS prevention with peers, and less so with family. They perceived cultural taboos around sex talk to be a barrier to open discussion of HIV/ADS. Students may need to acquire strategies to negotiate HIV/AIDS prevention approaches with family in the context of culture.     

Beliefs Contributing to HIV‐related Stigma in African and Afro‐Caribbean Communities in the Netherlands

Thirty years after the first diagnosis, people living with HIV (PLWH) around the world continue to report stigmatizing experiences. In this study, beliefs contributing to HIV‐related stigma in African and Afro‐Caribbean diaspora communities and their cultural context were explored through semi‐structured interviews with HIV‐positive (N = 42) and HIV‐negative (N = 52) African, Antillean and Surinamese diaspora community members in the Netherlands. Beliefs that HIV is highly contagious, that HIV is a very severe disease, and that PLWH are personally responsible for acquiring their HIV infection were found to contribute to HIV‐related stigma, as did the belief that PLWH are HIV‐positive because they engaged in norm‐violating behaviour such as promiscuity, commercial sex work, and, for Afro‐Caribbean diaspora, also homosexuality. These beliefs were found to be exacerbated and perpetuated by cultural taboos on talking about HIV and sexuality. HIV‐related stigma reduction interventions should focus on changing these beliefs and breaking cultural taboos on HIV and sexuality in a manner that is participatory and consistent with the current theory and empirical findings. Copyright © 2011 John Wiley & Sons, Ltd.     

Correlates of condom use and condom‐use motivation among young South Africans

A survey of South African secondary school students aged 12–17 years (n = 893) included measures designed to investigate relationships between beliefs about HIV/AIDS, condom use, interpersonal relationships, and two dependent measures: motivation to use condoms and reported condom use. We predicted that motivation would be an important correlate of reported condom use and that traditional cultural beliefs included in social cognition models would predict condom use motivation. Hierarchical multiple regression showed that 10% of the variance in reported condom use was accounted for by condom use motivation and age. Condom self‐efficacy, beliefs about condoms and injunctive norms accounted for much of the variance. Other beliefs included susceptibility to HIV and attribution of HIV to asexual sources such as witchcraft indicating that an expanded model of modifiable cognitions may be optimal when designing HIV interventions among young South Africans.     

Psychosocial correlates of condom use and their relationship with worry about STI and HIV in native and immigrant adolescents in Spain

The goal of this study was to analyze how worry about sexually-transmitted infections (STI) and HIV influences attitudes and self-efficacy towards condom use, HIV-related knowledge, HIV-perceived susceptibility and HIV-misconceptions in a multicultural sample in Spain. The sample was composed of 3,051 adolescents aged between 14 and 19 years old who lived in Spain. Of these, 67.7% were native Spaniards and the remaining 32.3% were Latin American immigrants. Results showed that worry about STI and HIV has a direct influence on condom use self-efficacy and HIV-knowledge and HIV-perceived susceptibility. Native Spanish adolescents showed higher positive attitudes towards condom use, greater HIV-knowledge and HIV-perceived susceptibility, and lower negative attitudes towards condoms use and HIV-misconceptions than Latin American adolescents. In the discussion, the importance of worry about STI and HIV is highlighted as a mediator variable that can predict risky sexual behavior and is related to cultural origin.     

艾滋病污名的形成机制、负面影响与干预

艾滋病污名主要包括实际污名、感知污名和自我污名, 这些不同形式的污名给艾滋病患者带来了精神上的痛苦、社会资源的剥夺等一系列的负面影响。归因理论、社会文化理论和道德理论分别从社会心理学、社会不平等和文化道德的角度阐述了艾滋病污名的形成机制。从这些机制出发, 减少艾滋病污名可以结合接触假设、知识传播以及认知行为疗法, 并注意改变艾滋病患者的自身观念。未来的艾滋病污名研究应更多地从社会文化以及道德的角度进行跨文化的量化研究。     

Spiritual and Religious Implications of Aging with HIV: A Conceptual and Methodological Review

ABSTRACT

Spirituality and religious practices can buffer people from stressful life circumstances and promote positive biopsychosocial outcomes. The beneficial effects of spirituality and religious practices have been documented in aging and HIV. Unfortunately, little is known about spirituality and religious practices in older adults with HIV. As the number of older adults with HIV increases, with an estimated 91,000 adults over 50 being diagnosed with this disease in the United States, spirituality and religious practices may help HIV-positive people to age successfully. Crisis competence and spiritual trajectories are ways of conceptualizing spiritual development when confronting aging with a life-changing event such as a being diagnosed with HIV. Methodological issues in studying spirituality in adults aging with HIV are identified including defining spirituality and religiosity, heterogeneity of the population, timing of diagnosis, mode of transmission, sexual orientation, religious and cultural stigma, and hardiness. Implications for possible interventions are also posited.     

HIV voluntary counselling and testing among recently initiated and traditionally circumcised men in the Eastern Cape Province of South Africa

HIV voluntary counselling and testing (VCT) is a cornerstone of the national strategic plan for HIV/AIDS treatment, care and support in South Africa. However, research shows that the utilisation of VCT services is disappointingly low, particular among males. This article focuses on the factors associated with the intention to test for HIV-infection among recently initiated and traditionally circumcised men in the rural areas of Eastern Cape Province, South Africa. Individual face-to-face interviews were conducted among 1656 sexually active men. Logistic regression analyses were used to explore the association between intention to test for HIV and psychosocial factors. Overall, 35.1% of the participants reported ever having tested for HIV. Intention to test for HIV was positively associated with perceived probability of getting an STI, positive attitudes towards gender-based violence, received general teachings about being a responsible man and highest grade passed. These findings provide specific information that can be used in the development of a focused cultural sensitive STI/HIV prevention programme aimed to increase VCT uptake among sexually active young men, which can be integrated into initiation and health education practices.     

Self-disclosure of HIV infection: preliminary results from a sample of Hispanic men.

We examined self-disclosure of HIV infection among 101 seropositive Hispanic men residing in Los Angeles. Results indicated that disclosure was highly selective and presumably influenced by the social, psychological, and material consequences of informing others about one's medical condition. Subjects tended to inform significant others such as parents, friends, and lovers than less significant others such as employers, landlords, and religious leaders. There was a relatively high rate of disclosure (75%) to doctors/dentists who were not treating subjects for HIV infection. Gay and bisexual subjects (89% of the sample) were more inclined to disclose their HIV serostatus to homosexual or bisexual others than to heterosexuals and to inform those who were aware of their sexual orientation. Disclosure increased with severity of disease independently of length of time since testing seropositive. Self-rated negative changes in appearance correlated with disclosure to less significant others. The role of cultural attitudes and values in self-disclosure of HIV infection is discussed.     

Insert Discourse: Rectal Douching Among Young HIV-Positive and HIV-Negative Men Who Have Sex with Men in Vancouver,Canada

Douching is a common practice among certain groups of women and MSM, and it is conducted for the purpose of cleanliness as part of bodily hygiene maintenance. Although there has been considerable research about female vaginal douching, understandings of rectal douching (RD) for MSM are limited. In the epidemiological and medical literature, RD is presented as a behaviour that removes beneficial bacteria and the surface epithelium layer of the colon, which can, potentially, increase the risk of HIV transmission in MSM. The paucity of research on male douching practices is curious given the primacy of anal sex in HIV prevention initiatives and the widespread nature of rectal douching among this population. This paper provides preliminary data on RD and is intended to engender a dialogue about male douching and the need for additional research into the cultural construction of the body among MSM, namely with respect to the anus. Findings were derived from qualitative interviews with 12 young HIV-positive men who had recently become HIV-infected and 12 HIV-negative age-matched counterparts who were participating in a prospective cohort study. Beliefs about RD differed according to HIV serostatus; HIV-positive men discussed the practice much more openly than their counterparts did. Pre-coital RD is an embedded behaviour about which very little is known. However, it is a critical issue to include in the development of effective HIV prevention strategies and warrants an acknowledgement of importance of the anus in the lives, sexual practices, and identities among MSM.     

A Pandemic of Terror and Terror of a Pandemic: American Cultural Responses to HIV/AIDS and Bioterrorism

Abstract. The cultural construction of American societal responses to the HIV/AIDS pandemic and terrorism is addressed. The use of metaphors of war, survival, extinction, and of those related to God in public narratives is analyzed. Issues of gender, sexuality, money, and power are also discussed within the context of the religion‐science dialogue. Suggestions are made about a possibility for a global ethic of survival based on an ethic of care.     

The impact of HIV illness on parents and children, with particular reference to African families

This paper looks at the effects of HIV infection on parenting and family relationships, focusing on the issues this presents for HIV families from sub-Saharan Africa, both here in the UK and in their countries of origin. We describe how we have experienced and dealt with some of the dilemmas facing parents and the context in which our service is offered. Despite the wide range of ethnic and cultural backgrounds, many common parenting issues and themes transcend cultural differences.     

Social and Cultural Sensitivity in Group-Specific HIV and AIDS Programming

In this article the authors encourage counselors and other human development professionals to provide HIV (human immunodeficiency virus) and AIDS (Acquired Immune Deficiency Syndrome) prevention programming that is sensitive to the social and cultural contexts of the specific group(s) addressed. The focus is on four groups that have been both the target for societal oppression and dramatically affected by the HIV and AIDS epidemic: women, gay and bisexual men, African Americans, and Latinos. First, information is provided to help professionals become more aware of the social and cultural contexts of behavior related to HIV and AIDS prevention in the four groups named. Second, four recommendations are made to assist professionals to sensitively apply that awareness to the planning and implementing of HIV and AIDS prevention programming. Four exemplar programs illustrate the implementation of these recommendations.     

Sex isn't that simple: culture and context in HIV prevention interventions for gay and bisexual male adolescents

Gay and bisexual male adolescents and young adults in the United States have been disproportionately impacted by the HIV pandemic. Despite the steadily increasing rise in their HIV infection rates, there has not been a commensurate increase in HIV prevention programs targeted to the unique social and sexual lives of these youths. Programs that address cultural and contextual factors that influence sexual risk and protective behaviors need to be developed, implemented, and rigorously evaluated. These interventions should address the potential influences of sexual and gay culture on the HIV risk/protective behaviors of gay and bisexual adolescents, as well as the influence of more traditional cultural factors related to ethnicity. The influence of contextual developmental factors should also be addressed. This may include an incorporation into prevention programs of the societal-level influences of heterosexism and masculinity ideology and the individual-level influences of sexual identity and ethnic identity development. Researchers and interventionists need to be creative and innovative in their HIV prevention approaches and ensure that programs are grounded in the lives and realities of gay and bisexual adolescents and young adults.     

Traditional Healing as Indigenous Knowledge: Its Relevance to HIV/AIDS in Southern Africa and the Implications for Counselors

This article integrates the results of several culture-based studies conducted over the past decade. Specifically, links are made between the continued relevance of the African traditional healer's corpus of knowledge, the efficacy of the healer's cultural authority, and the need for HIV/AIDS-related strategies and interventions that are culturally sensitive, especially counseling. Results of an initial investigation of traditional healing in Lesotho, Swaziland, and Zimbabwe are integrated with more recent research in Botswana and Namibia. Findings from these studies are meshed with preliminary results of an ongoing investigation of the contextual influences and cultural factors associated with the spread of HIV/AIDS in the southern African region. Outcomes of the combined investigations have supported further examination of traditional healing as an indigenous knowledge system, of its relevance to HIV/AIDS, and of its significance to professional counselors in Africa. Related recommendations are offered for consideration by those working within HIV/AIDS systems of intervention.     

Understanding the Relationships Among HIV/AIDS-Related Stigma,Health Service Utilization,and HIV Prevalence and Incidence in Sub-Saharan Africa: A Multi-level Theoretical Perspective

HIV-positive individuals often face community-wide discrimination or public shame and humiliation as a result of their HIV-status. In Sub-Saharan Africa, high HIV incidence coupled with unique cultural contexts make HIV-positive individuals particularly likely to experience this kind of HIV/AIDS-related (HAR) stigma. To date, there is a relatively small amount of high-quality empirical literature specific to HAR stigma in this context, supporting the notion that a better understanding of this phenomenon is needed to inform potential interventions. This paper provides a thorough review of the literature specific to HAR stigma in Sub-Saharan Africa, finding (a) qualitative support for the existence of important relationships between HAR stigma and health service utilization and barriers; (b) a need for more quantitative study of stigma and its relationships both to health service utilization and to HIV outcomes directly; and (c) a disconnect between methodological techniques used in this context-specific literature and well-known theories about stigma as a general phenomenon. This paper then draws from its empirical literature review, as well as from well-known theoretical frameworks from multiple disciplines, to propose a theoretical framework for the ecological and multilevel relationships among HAR stigma, health service utilization, and HIV outcomes in this context.     

Contemporary Myths, Sexuality Misconceptions, Information Sources, and Risk Perceptions of Bodabodamen in Southwest Uganda

This article reports findings from a study conducted among 212 private motorbike–taxi riders, locally called bodabodamen, from two study sites—a slum area and the urban center of Masaka town. Qualitative and quantitative methods were triangulated; a questionnaire, focus group discussions, in-depth interviews, case studies, and interactive workshops were all used. There were high levels of awareness of HIV, much more than sexually transmitted diseases (STDs), because many participants had closely experienced HIV/AIDS. Knowledge about sexual health contained several misconceptions, misinformation, and myths rooted in both the historical and contemporary social cultural context. Due to high illiteracy levels, bodabodamen cannot access many standard health education materials issued by government and private health organizations through the print and electronic media, as well as those published in languages other than the local vernacular. These (and possibly other) disadvantaged groups remain at risk of HIV and STDs. Especial efforts need to be made to provide appropriate health education.     

Individual,Interpersonal, and Sociostructural Factors Influencing Partner Nonmonogamy Acceptance among Young African American Women

In 2015 in the United States, the HIV diagnosis rate among African American women was 16 times that of White women, and HIV especially affected young African American women. African American women’s partnerships with nonmonogamous men may be one factor contributing to this disparity. Previous research has not adequately described factors influencing acceptance of partner nonmonogamy among African American women. To better understand this phenomenon, we interviewed 11 African American women aged 18–24 years-old who reported having sex in the past 3 months and reported knowing or suspecting a partner to have another female partner in the past 12 months. We employed a semi-structured interview guide designed to elicit in-depth, narrative responses from women about their partnerships. We used narrative analysis to interpret findings. Participants described factors that encouraged acceptance of partner nonmonogamy. These factors were social (i.e., limited partner availability, gender norms, and cultural norms), interpersonal (i.e., partner-specific comfort, sexual connection and emotional attachment, and casual partnership type), and intrapersonal (i.e., low self-esteem, loneliness, and fatalistic attitudes about nonmonogamy) in nature. The sociocultural context in which young African American women develop sexual partnerships may influence their attitudes, expectations, and behaviors within these partnerships and place them at increased risk for HIV and other sexually transmitted infections.     

Religious Influences on the Reproductive Health Decisions of HIV-Positive Latinas on the Border

The number of HIV-positive Latinas of child-bearing age living on the US–Mexico border is a growing concern. Little is known about how religious beliefs influence the reproductive health decisions of these women in light of disease demands and cultural and religious norms that support high fertility rates and childbearing. Such decisions may be further complicated by the stigma of HIV/AIDS and structural issues related to immigration status and trans-border lives. This paper analyzes extant literature and supports the need for further research so that policy makers and heath and social service providers can develop meaningful and comprehensive reproductive-health related interventions.     

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.