Dexter R. Voisin

HIV risks of men in methadone maintenance treatment programs who abuse their intimate partners: a forgotten issue.

Accumulating findings suggest a relationship between partner violence and HIV risk among women, however, this issue has yet to be adequately researched among men. This study examines the relationship between perpetrating intimate partner violence and HIV risk behavior among a sample of men in methadone maintenance treatment programs (MMTPs). Data were collected on 273 sexually active men, who were recruited from four inner-city MMTP clinics. More than a third of the sample reported perpetrating intimate physical abuse and 15% reported severe physical abuse in the past 12 months. Results from multiple logistic regression analyses indicate that after adjusting for demographic, poverty, and drug-use factors, men who abused an intimate partner were almost 4 times more likely to have more than one intimate partner, almost 3 times more likely to have unprotected anal sex, and 2.6 times more likely to have sex with a drug-injecting sexual partner than their counterparts. This study showed that men who perpetrated partner violence were at higher risk for HIV transmission. HIV prevention interventions need to consider the complex relationship between partner violence and HIV risk.

The Relationship Between Violence Exposure and HIV Sexual Risk Behaviors: Does Gender Matter?

This study examined the association between violence exposures and HIV risk behaviors among 409 adolescents and whether such associations are gendered. Results indicated that adolescents exposed to either childhood sexual abuse or family or community violence were almost 3 and 4 times more likely, respectively, than peers not exposed to such violence to report a higher number of HIV-related risk behaviors. In addition, boys exposed to family violence were almost 3 times more likely than girls to report multiple partners and use of drugs during sex. Findings suggest a complex relationship among violence, gender, and HIV risks among adolescents.

THE EFFECTS OF FAMILY AND COMMUNITY VIOLENCE EXPOSURE AMONG YOUTH: RECOMMENDATIONS FOR PRACTICE AND POLICY

Compared with other segments of the population, adolescents and, in particular, African Americans are disproportionately exposed to family and community violence. Research has consistently documented that exposure to such violence is often associated with psychological difficulties, poor educational and behavioral outcomes, and juvenile justice problems. Despite these compelling findings, many youth are not routinely assessed for such violence exposure and its ramifications by the educational, child welfare, social service, and juvenile justice systems with which they frequently interact. This article examines the prevalence of violence exposure within the family and community and its associated consequences among youth. Subsequently, the article proposes several practice and policy recommendations aimed at reducing the far-reaching effects of such violence exposure among youth.

Family ecology and HIV sexual risk behaviors among African American and Puerto Rican adolescent males.

This study examined the relationship between family ecology and HIV sexual risk behavior among African American and Puerto Rican adolescent males. Family, psychosocial, and HIV risk factors were assessed in 171 African American and 187 Puerto Rican adolescent males. Findings suggest that family ecology, culture, and gender role variables may differentially affect HIV sexual risk behaviors within these groups.

Witnessing Community Violence and Health-Risk Behaviors Among Detained Adolescents

This study examines whether witnessing community violence, in the 12 months prior to juvenile detention, is related and health-related outcomes in the 2 months prior to being detained among 550 youth. Participants answered survey questions using audio-computer assisted self-interviewing procedures, which assessed demographic, problem, and drug and sexual risk behaviors. Multiple logistic regression analyses, controlling for significant covariates, indicated that adolescents, in the last 12 months, who reported witnessing community violence, relative to their peer witnessing no violence, were in the last 2 months prior to being detained, twice more likely to have suicidal threats, 2 times more likely to use marijuana and alcohol, 2 times more likely to get high on alcohol or other drugs during sexual intercourse, and 2 times more likely to have sex with a partner who was high on alcohol or other drugs. Finding suggest that detained youth, many of whom may not access traditional health care, should be offered prevention and intervention services during detention, which provides a critical window of opportunity for needed services.

“You’re an Open Target to Be Abused”: A Qualitative Study of Stigma and HIV Self-Disclosure Among Black Men Who Have Sex With Men

The HIV/AIDS epidemic is a health crisis among Black men who have sex with men (MSM). HIV-related stigma presents a primary barrier to sexual communication and effective HIV prevention. Using in-depth, qualitative interviews conducted with 20 HIV-positive Black MSM between 2007 and 2008 in Chicago, Illinois, we explored the themes related to HIV-related stigma and the underlying messages HIV-positive Black MSM receive regarding their status. Stigmatizing messages stem from family, churches, and the gay community and from negative, internalized, beliefs HIV-positive Black MSM held about infected individuals before their own infection. HIV stigma influences sexual silence around HIV disclosure, especially to sexual partners.

Community Violence Exposure and Adolescent Delinquency Examining a Spectrum of Promotive Factors

This study examined whether promotive factors (future expectations, family warmth, school attachment, and neighborhood cohesion) moderated relationships between community violence exposure and youth delinquency. Analyses were conducted using N = 2,980 sixth to eighth graders (Mage = 12.48; 41.1% males) from a racially, ethnically, and socioeconomically diverse sample. After controlling for demographic factors, delinquency was positively associated with community violence exposure and inversely associated with each of the promotive factors. When interaction effects between all promotive factors and community violence exposure were examined simultaneously, only future expectations moderated the relationship between community violence exposure and delinquency. Specifically, community violence exposure had a weaker association with delinquency for youth reporting high versus low levels of future expectations. Results indicate that while promotive factors from family, school, and neighborhood domains are related to lower rates of delinquency, only future expectations served as a protective factor that specifically buffered youth from the risk effects of community violence exposure.

It's crazy being a Black, gay youth. Getting information about HIV prevention: a pilot study.

BACKGROUND Access and adoption of HIV prevention information are important criteria for reducing HIV infection rates among men who have sex with men. METHODS Using focus group data, researchers sought to identify sources of HIV prevention information and barriers to adopting protective behaviors among young African American men who have sex with men. Adolescents ages 18-24 were recruited for this study. Focus group data were analyzed to identify themes related to sources of HIV prevention information and barriers to adopting protective behaviors. RESULTS Researchers documented that family and friends, formal education, television, and the LGBT community were major sources for HIV prevention information. However, motivation for adopting such information was hampered by apathy, homophobia, and racism. CONCLUSION Feelings of powerlessness need to be addressed when targeting Black MSM with HIV prevention information.

A conceptual model of HIV disclosure in casual sexual encounters among men who have sex with men

HIV/AIDS continues to disproportionately impact men who have sex with men (MSM). Advances in highly active antiretroviral therapies (HAART) have successfully helped HIV-infected individuals lead longer, healthier, and presumably more sexually active lives. Consequently, secondary prevention approaches aimed at reducing the rate of HIV transmission have raised important questions about the role of sexual communication, namely HIV disclosure, as a primary target for intervention. This paper proposes a conceptual model of HIV disclosure in casual sexual encounters among MSM informed by Goffman’s work on stigma and based on existing empirical research. The article concludes with an agenda for research based in this integrative model.

Toward a Conceptual Model Linking Community Violence Exposure to HIV-Related Risk Behaviors Among Adolescents: Directions for Research

PURPOSE To present a conceptual framework which accounts for the relationship between community violence exposures (CVEs) and youth HIV risk behaviors. METHODS This article provides an overview of existing research on the links between CVE and HIV risk for youth and offers a conceptual framework for clarifying how CVE might contribute to HIV sexual risk behaviors. RESULTS Increasing empirical findings substantiate that the links between CVE and HIV risk behaviors among youth are mediated by psychological problem behaviors, low school success rates, and negative peer influences. CONCLUSIONS Researchers have identified the behaviors that place teens at risk for becoming infected with HIV. However, most scholars have overlooked the potential importance of CVE in influencing such behaviors. This article presents new directions for adolescent research and HIV interventions on the basis of an integrated conceptual framework.