Whole of community suicide prevention forums for Aboriginal Australians

It is well known that Aboriginal Australians are at increased risk of suicide. Contributors to suicide differ for Indigenous and non-Indigenous populations (Westerman, 2003; 2019). This study evaluated whole of community suicide prevention forums conducted across six locations. Attendees were youth (N = 136), service providers (N = 225), and community members (N = 158). The content of the forums was empirically based and, for service providers and community members, covered knowledge of suicide, and depression specific to Aboriginal people, skills relating to working with depressed and suicidal Aboriginal people, and intentions to help an Aboriginal person who is suicidal. Content for youth attendees focused on knowledge of suicide and depression, coping skills, intentions to help a friend, and beliefs about suicide. While the results demonstrated significant gains across most domains, there was a potentiating effect with some skills increases becoming more significant over each phase. This demonstrates that a whole of community approach to Indigenous suicide prevention is required, and that clinical and cultural skills require a longer-term approach for impact and sustainability.     

Family connectedness and women's sexual risk behaviors: implications for the prevention/intervention of STD/HIV infection

The present study explores the relationship between connectedness with the intergenerational family and women's sexual risk-taking as a guide to the development of family-focused prevention and intervention. Cross-sectional interview data from a pilot study were analyzed for correlations between a number of self-reported, risky sexual practices, the range of extended family members with whom the respondent was in contact, and awareness of stories pertaining to intergenerational family history. Structured interviews were administered by female interviewers to 56 women from two contexts: a STD (sexually transmitted disease) Clinic (N = 26), and an inner-city, Hispanic Community Organization (N = 30). Knowledge of stories about grandparents or great-grandparents was a robust predictor of lower sexual risk-taking in the STD Clinic sample. This relationship persisted, but only at the trend level in the Community Organization sample. In both the total sample and the STD subsample, the number of categories of extended family members with whom a respondent was in at least monthly contact was correlated with less sexual risk-taking. Given the fundamental importance of the family system as the primary social unit, these findings argue for further family theory-based research and for its potential application in the development of health prevention and intervention. Implications for practice and future research are discussed.     

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     

山西省艾滋病防治政策分析

阐述了艾滋病在山西省流行的现状,探讨了艾滋病引发的社会问题,分析了艾滋病防治条例、四免一关怀政策以及艾滋病自愿咨询与检测制度的执行情况以及在执行过程中所存在的主要问题,研究了山西省艾滋病防治工作相关基金的来源和使用情况,针对山西省在艾滋病防治工作中存在的问题,提出了艾滋病防治工作与社区工作相结合的建议。     

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.     

Working class homosexuality and HIV/AIDS prevention some recent research from Sydney,Australia

Abstract

Surveys on gay and bisexual men in Sydney and non-metropolitan New South Wales (NSW) indicate uneven patterns of HIV/AIDS knowledge and sexual behaviour change. As a follow-up action-research study, the Class, Homosexuality and AIDS Prevention (CHAP) project pursued audio-recorded, semistructured interviews with men in western Sydney and Nullangardie, a provincial city in NSW, to investigate the relationship between homosexuality and class.

One-to-one interviews with working-class, homosexually active men revealed particular patterns of homosexual initiation and sexual relationships, and a distinct culture being slowly affected by notions of being “gay” and “gay community”. This impact of modern gay life on western Sydney was different from that in the provincial city. More prominent were the effects of class—unemployment, poor education, poverty, and cultural marginalisation—on the experience and elaboration of homosexuality. Group interviews confirmed an experience of “difference” from prominent gay communities, especially Sydney's “Oxford Street” gay quarter. Working-class men offered a critique of gay community-initiated HIV/AIDS prevention strategies, pointing toward different education initiatives involving local social networks.

Case studies are presented to argue the importance of the relation between sexuality and class, and its consequences for HIV/AIDS education.     

Using Concept Mapping to Operationalize Mental Well-Being for Men and Boys

A primary purpose of many prevention-oriented interventions is to improve the general well-being and quality of life for individuals and their communities. Unfortunately, well-being is often poorly defined, with definitions embracing related issues of quality of life, happiness, and physical health. Mental well-being as a concept is also poorly defined, particularly for different population groups. As part of a larger study to assess community-level prevention efforts aimed at men and boys, a participatory approach was used to operationalize mental well-being from a male-centered, community-based perspective using concept mapping. A set of 96 statements perceived as important aspects of mental well-being for men and boys were developed and sorted by 90 participants from the study communities. The 8-cluster solution was selected as the most parsimonious and the best conceptual fit in relation to the mental well-being concept, namely, positive self-worth, supportive community, community connections, positive masculinity, responsive institutions, strong social connection, dignity and respect, and safety. These eight clusters of mental well-being, which were classified into two overarching domains of socio-environmental and emotional well-being, can provide a basis by which to assess community-based programs aimed at this population.     

A preliminary study of a traumatic injury prevention program

Abstract

This study examined the long-term impact of a five component spinal cord injury prevention program presented to adolescents. A sample of 445 teenagers who attended a junior high school in which an educational intervention was presented three years earlier and a control group of 379 students who had not been exposed to the intervention completed a questionnaire assessing their safety knowledge, attitudes, and self-reported behaviors. Total scores on the questionnaire between treatment and control groups differed significantly. Students in the treatment group reported significantly more frequent seat belt use, stronger belief that seat belts were important to their safety, lower likelihood of riding with friends who had been drinking, higher rates of friends' use of seat belts, greater awareness of the age group most likely to be injured, and increased knowledge that they could prevent spinal cord injury.     

Biblical narratives for positive psychology and suicide prevention: an evidence supported approach

Suicide is the ultimate outcome of a tragic view of life that is prevalent in ancient Greek writings. Indeed, over 16 suicides and self-mutilations can be found in the 26 surviving tragedies of Sophocles and Euripides. In contrast, only six suicides can be found in the Hebrew Scriptures, and only one suicide in the Christian Scriptures. In addition, the Hebrew Scriptures present numerous suicide-prevention narratives that are psychologically instructive. This paper examines evidence regarding seven risk factors for suicide and contrasts Greek and Biblical narratives to underscore the clinical and theoretical utility of the Biblical approach: (1) Feeling isolated and ignored; (2) Feeling one’s life is meaningless; (3) Feeling exiled from one’s home or homeland; (4) Feeling unable to be oneself with others; (5) Feeling alone in one’s life mission; (6) Feeling abandoned by one’s child; and (7) Feeling doomed by a dysfunctional family of origin.     

Multidimensional Family Therapy HIV/STD Risk-Reduction Intervention: An Integrative Family-Based Model for Drug-Involved Juvenile Offenders

Drug and juvenile justice involved youths show remarkably high rates of human immunodeficiency virus (HIV)/sexually transmitted disease (STD) risk behaviors. However, existing interventions aimed at reducing adolescent HIV risk behavior have rarely targeted these vulnerable young adolescents, and many approaches focus on individual-level change without attention to family or contextual influences. We describe a new, family-based HIV/STD prevention model that embeds HIV/STD focused multifamily groups within an adolescent drug abuse and delinquency evidence-based treatment, Multidimensional Family Therapy (MDFT). The approach has been evaluated in a multisite randomized clinical trial with juvenile justice involved youths in the National Institute on Drug Abuse Criminal Justice Drug Abuse Treatment Studies ( http://www.cjdats.org ). Preliminary baseline to 6-month outcomes are promising. We describe research on family risk and protective factors for adolescent problem behaviors, and offer a rationale for family-based approaches to reduce HIV/STD risk in this population. We describe the development and implementation of the Multidimensional Family Therapy HIV/STD risk-reduction intervention (MDFT-HIV/STD) in terms of using multifamily groups and their integration in standard MDFT and also offers a clinical vignette. The potential significance of this empirically based intervention development work is high; MDFT-HIV/STD is the first model to address largely unmet HIV/STD prevention and sexual health needs of substance abusing juvenile offenders within the context of a family-oriented evidence-based intervention.     

Effects of incentives in web-based prevention for adolescents: Results of an exploratory field study

This study examines if the willingness of adolescents to participate in a web-based prevention program can be increased by providing an incentive for participation. Eighth graders (n = 166) were instructed to work on an online stress-prevention program via the internet from home. A subgroup of n = 80 subjects from three school classes were told that they would take part in a raffle if they completed the program. The remaining n = 86 participants (again three classes) served as a control group. The school classes were randomly allocated to the training conditions. During the 8-week intervention period, compliance rates were recorded by means of an online tracking system. In addition, self-reported compliance and training acceptance were assessed. The application of an incentive had considerable effects on retention rates, on training acceptance and self-assessed effectiveness of the intervention. Adolescents in the ‘incentive condition’ completed three times as many program lessons as control subjects did, and–as their self-reports suggest–they worked as attentively. Validity of self-reported compliance was higher among participants of the incentive group and they reported significantly higher program acceptance. As a consequence, the application of incentive systems is recommended for future implementation of web-based prevention programs targeting adolescents.     

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.     

Changes in health status after one year for persons at-risk for and with HIV infection

Abstract

Health status is an important component of the evaluation of patient outcome in HIV infection where disease is chronic, progressive, and debilitating. This paper compares patient self-report for 9 dimensions of health status for patients followed in ATHOS (AIDS Time-Oriented Health Outcome Study). We compared changes in functioning after 12 months for 1, 524 patients with varying HIV disease severity: 238 asymptomatic, 447 symptomatic, 441 AIDS, and 398 HIV-negative individuals who are at-risk for infection.

Declines in health status were observed for all HIV-infected persons, including also asymptomatic patients. Individuals with symptomatic disease or AIDS had significant declines (p < 0.001) in physical functioning, energy, global health, pain, and increased disease symptoms, but no significant declines in health distress, cognition, or mental health. Persons with AIDS had greater declines than those with symptomatic disease. All HIV-infected individuals reported significantly fewer hours at work and more disability days than HIV-negative patients from similar risk pools. The adverse impact that HIV infection has on the health status of HIV-positive asymptomatic individuals is striking; HIV-negative individuals are more similar to HIV-positive individuals than to the general population.     

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。     

The long-term outcome of a personal network-oriented HIV prevention intervention for injection drug users: The SAFE study

Social influence processes have been found to affect numerous drug and health-related behaviors. We postulated that by using a network-oriented intervention it may be possible to capitalize on social influence processes to reduce human immunodeficiency virus (HIV) risk behaviors. The present study used an experimental study design for delivering a psychoeducational acquired immunodeficiency syndrome (AIDS) preventive intervention to injection drug sharing networks. Participants were recruited from the ALIVE study, an epidemiological study in Baltimore. In the present paper we examine the self-reported behavioral outcomes of 117 injection drug users 18 months after the baseline interview. HIV seronegative experimental participants reported significantly less frequent needle sharing and less injecting of heroin and cocaine than controls. In multiple logistic regression models of HIV seronegative participants, there was a significant negative association between assignment to the experimental group and the HIV-related behaviors of needle sharing and sharing of cookers in the prior 6 months; controls were 2.8 times more likely than experimentals to report needle sharing and were 2.7 times more likely to report sharing cookers. The results of this 18-month follow-up suggest that among injection drug users network-oriented interventions may be a promising approach to HIV prevention.     

HIV-positive pregnant women attending the prevention of mother-to-child transmission of HIV/AIDS (PMTCT) services in Ethiopia: economic productivity losses across urban-rural settings

HIV/AIDS impacts significantly on pregnant women and on children in Ethiopia. This impact has a multiplier effect on household economies and on productivity losses, and is expected to vary across rural and urban settings. Applying the human capital approach to data collected from 131 respondents, this study estimated productivity losses per HIV-positive pregnant woman–infant pair across urban and rural health facilities in Ethiopia, which in turn were used to estimate the national productivity loss. The study found that the annual productivity loss per woman–infant pair was Ethiopian birr (ETB) 7,433 or United States dollar (US$) 378 and ETB 625 (US$ 32) in urban and rural settings, respectively. The mean patient days lost per year due to inpatient admission at hospitals/health centres was 11 in urban and 22 in rural health facilities. On average, urban home care-givers spent 20 (SD = 21) days annually providing home care services, while their rural counterparts spent 23 days (SD = 26). The productivity loss accounted for 16% and 7% of household income in urban and rural settings, respectively. These high and varying productivity losses require preventive interventions that are appropriate to each setting to ensure the welfare of women and children in Ethiopia.     

Perceived responsibility for disease onset affects HIV/AIDS Education

Abstract

Ninety-nine participants were assigned to one of three experimental conditions in which they viewed an AIDS education videotape that systematically manipulated whether or not the educator would be perceived as responsible for HIV infection. Participants were administered pre and post-video affect measures, and an HlV/AIDS knowledge test after watching the video. Participants who viewed the speaker who acquired HIV through a blood transfusion (perceived not responsible) and those who viewed the speaker who did not reveal mode of acquisition (control) performed significantly better on the knowledge test compared to those who viewed the speaker who acquired HIV through unprotected sexual inttrcourse (perceived responsible). In addition. male participants in the perceived responsible condition reported a significant increase in sensation-sceking after viewing the video. Finally, females experienced a significantly greater increase in anxiety as a result of seeing the video than did males. Implications of these tindings for the design and implmentation of AIDS education programs were discussed.     

Impact of educational intervention on willingness-to-pay for suicide prevention: a quasi-experimental study among university students in Japan

Many individuals show negative attitudes toward the use of taxes for suicide prevention. Activities that enhance knowledge and awareness of suicide and suicide prevention may increase willingness to pay (WTP) for suicide prevention. WTP is the amount that a consumer will pay for a product or service. The present study examined the influence of educational activities on enhancing knowledge and awareness of suicide and its prevention on WTP. We conducted a quasi-experimental study to examine the influence of lectures on suicide by comparing the amount of change in WTP between two groups over the same period: an intervention group (n = 92) comprising students who participated in the lectures and a control group (n = 128) comprising general university students recruited through an Internet-based survey. A t-test showed that the amount of change was significantly larger in the intervention group (t (152.31) = 2.25, p = .026). Ordinal logistic regression analysis showed that increased WTP was significantly correlated with an annual household income of JPY 4–6 million or higher. It may be appropriate to conclude that participation in lectures about suicide is effective in increasing WTP for suicide prevention.