Gender Roles,Power Strategies,and Precautionary Sexual Self-Efficacy: Implications for Black and Latina Women's HIV/AIDS Protective Behaviors

This cross-sectional study tested a conceptual model of women's HIV/AIDS protective behaviors using gender roles, relationship power strategies, and precautionary sexual self-efficacy as predictors in a predominantly Black and Latina community sample of heterosexual women (N = 125). Results revealed no support for the full model, but partial confirmation for several components of the model. Education significantly predicted gender roles, and gender roles and use of direct power strategies were significant predictors of sexual self-efficacy. Most of the participants were married or partnered and were unconcerned about contracting HIV, suggesting that if women perceive that they are at low or no risk, their gender roles, power strategies, and precautionary sexual self-efficacy will be inconsequential to their HIV/AIDS risk reduction practices.     

Predictors of Condom Use in Mexican Migrant Laborers

The purpose of this study was to explore predictors of condom use with occasional sex partners and regular sex partners, as well as carrying condoms in a new high-risk group for HIV infection, Mexican migrant laborers. This study extends previous findings by (1) exploring additional predictors not previously examined, (2) utilizing a large sample of male and female Mexican migrant laborers, (3) carefully controlling for the effects of various demographic and lifestyle variables related to condom use, and (4) assessing the interactive effects of gender on predictors of condom use. Snowball sampling was used to survey 501 adult Mexican migrant laborers. Results revealed that condom use with occasional sex partners was predicted by carrying condoms and condom self-efficacy and that women were more likely to use condoms with occasional partners when both men and women knew someone with HIV/AIDS. Condom use with regular sex partners was predicted by procondom social norms, less negative attitudes toward condoms, not knowing someone with HIV/AIDS, and condom self-efficacy. Carrying condoms was predicted by procondom social norms, less negative attitudes toward condoms, condom self-efficacy, worry about contracting HIV/AIDS, and women were more likely than men to carry condoms when both men and women were married. Understanding these findings, future research directions, and implications for condom promotion strategies with Mexican migrant laborers are discussed.     

Gender Relations and HIV Transmission in North-Central Nigeria

Nigeria’s most recent National HIV/AIDS and Reproductive Health Survey of 2012 shows a decline in the national prevalence rate from 3.6% in 2007 to 3.0% in 2012. Despite this moderate decrease, the rate for the North-central geopolitical zone: (5.7 and 3.4%, respectively) remained higher than the national average for both years. Besides, virtually all of the HIV and AIDS surveys conducted in Nigeria from 1999 till date have consistently shown higher rates among females than males. For instance, it was 4.0 and 3.5% among females; and 3.5 and 3.3% in males in 2007 and 2012 respectively. UNAIDS reported that studies on the mode of transmission in 2008 found the bulk of new infections among cohabiting and married sexual partners who are not engaged in high risk sex (42.2%) compared to casual heterosexual sex (9.1%) and sex workers (3.4%). Higher vulnerability among married females implies higher risk of parent to child transmission, yet married women are perceived as a “low risk” group. Against this backdrop, I studied some gender related socio-cultural factors that influence HIV transmission among married women in two ethnic groups in North-central Nigeria. Results of the qualitative study conducted through 24 in-depth interviews and 36 focus group discussions in six communities indicate that marital consent; women’s poor access to safe sex; double standards in marital sexual practices; gender based violence against women; among others influence the spread of HIV infection in married heterosexual couples. In conclusion, marriage does not necessarily reduce HIV vulnerability in women.     

AIDS and condom-related knowledge,beliefs, and behaviors in Mexican migrant laborers

A survey of 87 Mexican migrants (55 males and 32 females) who have lived and worked in the US since 1982 assessed AIDS and condom-related knowledge, beliefs, and sexual practices. Although respondents were highly knowledgeable about major modes of HIV transmission, one-third to one-half believed that HIV could be contracted from mosquito bites, public bathrooms, kissing, and the HIV test. Only 15% knew someone with AIDS. Ever-use of condoms was reported by 70.9% of men and 41.9% of women. Of the 68 subjects who had been sexually active in the year preceding the survey, 20 reported two or more partners. Among sexually active respondents, 16.2% always used condoms with their primary partner, while 43.0% used condoms consistently with occasional partners. 48.9% of men and 57.1% of women never used condoms with their primary partner; with casual partners, these rates were 30.8% and 44.4%, respectively. Worry about contracting AIDS, self-rated on a scale from 1 (very often) to 4 (never), averaged 2.84, with higher worry scores among those 18-31 years of age and with multiple partners. Respondents did not anticipate negative consequences of condom use (e.g., reduced sexual pleasure), but females expressed concern that carrying condoms would cause them to be viewed as promiscuous.     

A short-term group treatment model for gay male survivors of childhood sexual abuse living with HIV/AIDS

HIV-positive gay male survivors of childhood sexual abuse (CSA) face three layers of trauma: childhood abuse, homophobic oppression, and HIV/AIDS. Additionally, CSA has been shown to increase HIV risk behavior among gay men, and the trauma of HIV infection often parallels the experience of CSA. Effective coping strategies are particularly important for people living with HIV/AIDS in order to adapt to physical, psychological, and social implications of infection. However, coping strategies once adaptive in the context of CSA may become maladaptive in adulthood. Interventions are needed that enhance coping and address CSA for survivors living with HIV/AIDS to protect their own health and to prevent new transmissions. This article presents a group model found to be efficacious for treating gay male survivors of CSA living with HIV/AIDS.     

The Influence of Gender-related Factors on HIV Prevention among Chinese Women with Disrupted Marital Relationship

Two-hundred-and-thirty-one Chinese women were individually interviewed on their HIV-prevention behavior and gender-related psychosocial factors. Compared to women with intact marriages, women with marital disruption endorsed more inaccurate information about HIV/AIDS, had less worry about contracting HIV from their husbands, and were less likely to use condoms in current and future sexual activities. Among sexually active Chinese married women, rates of condom use in the past 6 months were 60% for the intact group and 38% for the disrupted group. Factors that discriminated between condom non-users and users among sexually active women in the disrupted group included: conservative gender attitudes toward sexuality and sexual decision-making, negative attitudes toward condom use, and lack of concern about contracting HIV from their husbands.     

Predictors of Risky and Precautionary Sexual Behaviors Among Single and Married White Women1

Risky and precautionary sexual behaviors were examined in a community sample of 260 single and married/cohabitating White women. Structural equation modeling was used to assess the ability of age, socioeconomic status (SES), marital status, religiosity, and 9 health belief constructs to predict risky sexual behavior with one's partner, using a barrier method of birth control, unintended pregnancies, and number of sexual partners in the past year. The pattern of results suggests that single White women appear to feel more vulnerable to HIV and STD infection and more likely to engage in risky sexual behavior than do married White women. The discussion focuses on the importance of sociocultural factors in understanding risk behaviors within the social context of relationship status, the complexity of the concept of risk reduction, and the need for going beyond the health belief model in order to develop different HIV prevention strategies for single and married White women.     

Infant birth weight among women with or at high risk for HIV infection: the impact of clinical, behavioral, psychosocial, and demographic factors.

The purpose of these analyses was to provide a prospective examination of the impact of HIV on birth weight using clinical, behavioral, psychosocial, and demographic correlates. HIV-positive (n = 319) and HIV-negative (n = 220) pregnant women matched for HIV risk factors (i.e., drug use and sexual risk behaviors) were interviewed during the 3rd trimester of pregnancy and 6 weeks postpartum. Medical chart reviews were also conducted for the HIV-seropositive pregnant women to verify pregnancy-related and birth outcome data. In a logistic regression analysis, model chi2(9, N = 518) = 124.8, p < .001, controlling for parity and gestational age, women who were HIV seropositive were 2.6 times more likely to have an infant with low birth weight. In addition, Black women and those who did not live with their partners were more than 2 times as likely to have infants with low birth weight, and those who smoked were 3.2 times more likely to have infants with low birth weight. Knowing that women with HIV, those who are Black, and those not living with a partner are at highest risk for adverse birth outcomes can help those in prenatal clinics and HIV specialty clinics to target resources and develop prevention interventions. This is particularly important for women with HIV because birth weight is associated with risk of HIV transmission from mother to child.     

Changes in HIV treatment beliefs and sexual risk behaviors among gay and bisexual men, 1997-2005.

OBJECTIVE: Beliefs about HIV treatment effectiveness and the impact of HIV treatments on HIV transmission risks were initially related to sexual risk-taking in the late 1990s when multidrug HIV treatments first became available. This study examined changes in beliefs about the effects of HIV treatment for preventing HIV transmission and their association to sexual risk behaviors between the years 1997 and 2005. DESIGN: Anonymous surveys were administered to a convenience sample of gay and bisexual men attending a large community event in Atlanta, Georgia in 1997 (N = 498) and again at the same community event in 2005 (N = 448). Analyses were performed for men living with HIV/AIDS and for men who have not been diagnosed with HIV/AIDS. MAIN OUTCOME MEASURES: Rates of unprotected anal intercourse in the previous 3 months. RESULTS: There were significant increases in high-risk sexual practices that coincided with increased beliefs that HIV treatments can reduce the chance of transmitting HIV. However, optimistic beliefs about the health benefits of HIV treatments decreased over the 8 years and were not related to risk behaviors. CONCLUSIONS: Beliefs about how HIV treatments impact HIV infectiousness remain associated with HIV transmission risk behavior and interventions targeting at-risk as well as HIV-positive men who have sex with men must directly address these beliefs and perceptions.     

Culture and Gender Sensitive AIDS Prevention With Mexican Migrant Laborers: A Primer for Counselors

The purpose of this article is to explicate research-informed culture and gender sensitive AIDS prevention strategies aimed at Mexican migrant laborers living and working in the United States for extended time. This unique and extremely marginalized Latino population is yet another emerging high risk group for contracting the HIV virus. Counselors interested in applying their knowledge of psychology and minority groups to preventing such an AIDS epidemic will be challenged by the complex factors that frame this problem.     

Risky Sexual Behaviour Among Married and Cohabiting Women and its Implication for Sexually Transmitted Infections in Mahikeng,South Africa

Risky sexual behaviour continues to be the main means through which sexually transmitted infections (STIs) and HIV are spread in South Africa. However few studies have assessed risky sexual behaviour among married and cohabiting women in this high HIV prevalence country. The aim of this study was therefore to assess the prevalence and identify the predictors of risky sexual behaviour among married and cohabiting women in Mahikeng Local Municipality where HIV is generalized. The study used cross-sectional mixed methods data obtained from 568 women responding to a survey and 33 women participating in in-depth interviews in 2012. All the women were aged 18–49 years, married or cohabiting and were residing in rural and urban areas of Mahikeng Local Municipality at the time of the study. The data was analyzed by the use of the Chi square statistic and a parsimonious binary logistic regression model, and the thematic content analysis method. The study found that 4 in 10 of the women experienced risky sexual behaviour, which was significantly predicted by being in marriage or cohabitation for <5 years, having a partner working in agriculture, government and mining sectors, having sex to achieve motherhood, having the perception by the women that they were unlikely to contract STIs, having the belief that partners have the right to use force to obtain sex and having partners who were unwilling to use condoms. All the above predictors were exacerbated by culturally sanctioned gender inequality and structural factors. The findings suggest that risky sexual behaviour is prevalent among married and cohabiting women in the study area which has serious implication for the marital transmission of STIs and HIV. We suggest interventions that enhance gender equality in sexual decisions and initiatives that encourage men to change their sexual beliefs and values.     

Ethical aspects of HIV/AIDS prevention strategies and control in Malawi

HIV/AIDS prevention campaigns have been overshadowed by conflicting, competing, and contradictory views between those who support condom use as a last resort and those who are against it for fear of promoting sexual immorality. We argue that abstinence and faithfulness to one partner are the best available moral solutions to the HIV/AIDS pandemic. Of course, deontologists may argue that condom use might appear useful and effective in controlling HIV/AIDS; however, not everything that is useful is always good. In principle, all schools of thought and faith seem to agree on the question of faithfulness for married couples and abstinence for those who are not married. But they differ on condom use. On the ground, the situation is far more complex. We simply lack a single, entirely reliable way to resolve all disagreements regarding HIV/AIDS prevention strategies.

Portraits of Well-Being: Photography as a Mental Health Support for Women With HIV

Many women living with HIV/AIDS (WL-HIV/AIDS) experience significant mental distress. Although creative arts strategies are well positioned to help support women by inspiring creativity and meaning-making, few arts programs have been implemented and evaluated with this population. The authors conducted a photography project with 30 WL-HIV/AIDS from three United States cities. Participants took pictures to capture their lives with HIV/AIDS and described their photos and stories in group and individual sessions. Using thematic analysis, the authors identified that the project supported women’s mental health in four ways by facilitating empowerment and helping women to express themselves, address their mental health with new tools like photography, and process past traumas. Photography projects may help WL-HIV/AIDS understand and manage their mental health.     

Psychological trauma associated with AIDS and HIV infection in women

The growing numbers of women faced with HIV infection and AIDS has specific counselling implications. This paper analyses the psychological needs of all women patients seen by the psychology department (n = 33) over the past 12 months. The mean age was 32.3 years. Psychological crisis was high. Four women reported rapes (three accounting for their HIV infection). Two women had suicide attempts (one on two occasions), Death experiences were notable, including multiple bereavement. Conjidentiality was problematic for many of the women. Problems were reported around pre- and post-test counselling which was absent for three women, and often surrounded the diagnosis of a loved one (child, husband or partner). Most women were first seen as in-patients (when disease progression was extensive) or when their partners or children were in-patients. Despite offers of out-patients follow-up, only four HIV + ve women attended, three of which were irregular. A group of ten women were only seen indirectly when provision of care wasgiven to their children. A consistent group were seen with worries about HIV (either due to sexual contact with a known HZV+ ve or at risk individual) or to unfounded concerns often reflecting underlying psychological problems. This paper explores the counselling challenges of AIDS and HIV for women.     

“Whenever Jack sees a condom,he falls asleep”: experiences of condom use and erectile disorder among HIV positive men in a Zimbabwean rural setting

In this qualitative inquiry, we set out to explore the experience of condom use and erectile disorder (ED) among men living with HIV in a rural district of Zimbabwe. Data on condom use related erectile disorder with antiretroviral (ART) medication were collected from a purposive sample of 18 men living with HIV and AIDS (age range 23–54 years). These data were supplemented with those from a convenience sample of 23 women living with HIV who self-identified as partners of men living with HIV and AIDS (age range 26–37 years). The data were thematically analyzed. Results suggest that men attributed their experiencing of erectile problems to two main explanations: use of condoms and ART medication. These men reported inconsistent use of condoms and/or adherance to ART therapy due to a belief that these cause their ED. The women informants reported similar observations, including the shared gendered perspective that the men perceived a loss of sense of manhood from ED. Beliefs that influence health promotion with men living with HIV and AIDS are important to public health interventions with them.     

Sex and the Right to HIV/AIDS Education in Early Childhood

This study explored how early childhood teachers (n=5) and young children (n=174) (age range 7 to 8 years; males = 81; females = 93) in two primary schools constructed and interpreted the right to HIV/AIDS education. Data were captured using individual interviews with teachers and group interviews with young children. Analysis of the data showed that teachers viewed young children's right to health information positively but did not consider the right to sexual information. Teachers operated within discourses which upheld the image of the child as innocent requiring protection from sexual knowledge. Children's perceptions of their rights to knowledge of sex in HIV/AIDS education showed ambiguity. Some accepted the right to know whilst others felt that knowledge about HIV/AIDS was inconsistent with childhood innocence.     

HIV-related stigma among market workers in China.

HIV-related stigma was examined among 209 employees and owners of stalls in 5 markets in an eastern coastal city in China. Of the participants 53% were women and 47% were men; 100% were Han. Ages ranged from 18 to 49 years (M=35, SD=8.1). Half of the participants believed that punishment was an appropriate response toward those living with HIV (50%). Over half (56%) were unwilling to be friends with infected individuals. The majority thought that those living with HIV should be isolated (73%). They agreed that persons living with HIV should not take care of other people's children (85%). Punishing beliefs toward persons living with HIV were related to being male, older, married, less educated, and unwilling to be tested for HIV.     

Predictors of HIV-related stigma among young people living with HIV.

Enacted and perceived HIV stigma was examined among substance-using young people living with HIV (YPLH) in Los Angeles, San Francisco, and New York City (N = 147). Almost all YPLH (89%) reported perceived stigma, and 31% reported enacted experiences in the past 3 months; 64% reported experiences during their lifetime. The HIV stigma questions were characterized by factors of avoidance, social rejection, abuse, and shame. In multivariate models, enacted stigma was associated with gay or bisexual identity, symptomatic HIV or AIDS, and bartering sex. Perceived stigma was associated with female gender, symptomatic HIV or AIDS, bartering sex, lower injection drug use, and fewer friends and family knowing serostatus. Gay or bisexual YPLH who were also HIV symptomatic or AIDS diagnosed experienced more HIV stigma than their heterosexual peers.     

“Getting to Know”: Exploring How Urban African American Women Conceptualize Safer and Risky Sexual Behaviors

The surge in the rate of the Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) cases continues to be most prevalent for African American women between the ages of 18 and 29, with heterosexual transmission remaining the primary cause of HIV spread for this population. The high rates of HIV/AIDS among African American women continue to emphasize the need for understanding how members of this population conceptualize sexual safety and risk. A qualitative research study using grounded theory methods was conducted to explore how African American women define safer and risky sexual behaviors. Interviews were conducted with 14 African American women between the ages of 18 and 29. The study findings suggest that African American women’s definitions of safer and risky sexual behaviors, while in a consensual sexual relationship, are consistently influenced by sex partner type. The information garnered from this study can help inform the development of HIV prevention strategies, health education, counseling and reproductive health services that support African American women’s wellness.     

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.