Gwendolyn Childs

Support, Stigma, Health, Coping, and Quality of Life in Older Gay Men With HIV

&NA; As life expectancy for persons living with HIV has increased due to antiretroviral therapy, quality of life (QOL) has become an emerging issue for older gay men with HIV, who comprise more than 50% of older adults living with HIV in the United States. The purpose of this study was to determine predictors of QOL in older gay men with HIV. Sixty gay men ages 50–65 participated. Age, social support, and problem‐focused coping were significantly and positively correlated with QOL, while medical comorbidities, social stigma, and emotion‐focused coping were all significantly and negatively associated with QOL (p < .01). In stepwise linear regression analysis, emotional/informational support remained as a significant positive predictor, and medical comorbidities, HIV stigma, and emotion‐focused coping remained as significant negative predictors, accounting for 64% of the variance in QOL. Study findings may help researchers develop interventions aimed at increasing QOL in this population.

The Multiple Stigma Experience and Quality of Life in Older Gay Men With HIV

&NA; Older HIV‐infected gay men may experience multiple forms of stigma related to sexual orientation (homonegativity), HIV (HIV stigma), and age (ageism), all of which can negatively impact quality of life (QOL). Our purpose was to determine predictors of homonegativity, internalized HIV stigma, and ageism, and stigma experiences that were predictive of QOL. Sixty HIV‐infected gay men, ages 50–65 years, participated. Younger age and emotion‐focused coping were significantly predictive of homonegativity, accounting for 28% of variance. Younger age, support group participation, medications per day, social support, and emotion‐focused coping predicted internalized HIV stigma, accounting for 35% of variance. Problem‐focused coping predicted ageism, accounting for 7% of variance. In regression analysis, the three types of stigma accounted for 39% of variance in QOL (homonegativity 19%, internalized HIV stigma 19%, ageism 0.5%). Study findings may help researchers develop interventions to alleviate multiple stigma experiences of HIV‐infected older gay men, thus improving QOL.

The moderating effect of sexual pressure on young urban women's condom use.

The purpose of this study was to examine whether womens experiences of sexual pressure moderated the relationship between sexual empowerment determinants and condom use in a sample of 100 high-risk women, ages 19-25. Five sexual empowerment determinants of condom use were identified from the literature: HIV knowledge, self-esteem, condom self-efficacy, positive attitudes toward condom use, and condom negotiation skills. Linear and logistic regression analyses revealed that positive attitudes toward condom use and condom negotiation skills were significant predictors of condom use. These relationships, however, were moderated by sexual pressure. Findings indicate that womens experiences with sexual pressure have the potential to decrease the likelihood of condom use, even though other sexually protective behaviors may be exhibited.

Correlates of sexual abstinence and sexual activity of low-income African American adolescent females.

&NA; The purpose of this predictive correlational study was to examine antecedent (knowledge of HIV and spirituality) and psychosocial (attitude toward abstinence, attitude toward condom use, sexual self‐efficacy, and perceived parental attitudes toward premarital sex) factors derived from the theories of reasoned action and planned behavior as correlates and predictors of both sexual abstinence and sexual activity. Additionally, this study identified the sexual practices (vaginal‐penile, oral, and/or anal sex) in which African American adolescent females were most likely to engage. A sample of 94 African American adolescent females from low‐income housing communities completed questionnaires. Major results included the following: (a) a high rate of sexual abstinence was reported, (b) age was the only significant predictor of condom use, and (c) sexual self‐efficacy was not a significant predictor of engaging in sexual activity. The study results contribute to the development of HIV risk reduction programs and extend health care providers’ knowledge of sexual counseling for adolescents.

Successful aging with HIV: a brief overview for nursing.

Adults age 50 and older with HIV represent approximately 20% to 25% of the entire HIV population in the United States. This unique clinical population is expected to grow; therefore, understanding how to facilitate successful aging in this population is needed. Issues that can negatively affect successful aging with HIV have been identified, and include social isolation, suicidal ideation, HIV-related stigma, cognitive decline, sarcopenia, HIV-medication toxicity, osteoporosis, and fatigue. This brief overview provides nurses with specific insights for practice, intervention, and research.

Digital Gaming for HIV Prevention With Young Adolescents

&NA; The search for intervention strategies appropriate for young adolescents has recently led to the use of digital games. Digital gaming interventions are promising because they may be developmentally appropriate for adolescent populations. The gaming approach also capitalizes on an inherent interest to adolescents and circumvents traditional barriers to access to prevention interventions faced in some geographical areas. Notwithstanding, research on gaming in HIV prevention is quite limited. In this review article, we examine the need for contextually relevant HIV prevention interventions among young adolescents. From this, we provide a theoretical framework for exploring contextually relevant HIV risk factors and a foundation for gathering and using input from the target population to adapt an existing game or to create a developmentally appropriate and contextually relevant HIV prevention game.

Challenges of Depression and Suicidal Ideation Associated With Aging With HIV/AIDS: Implications for Social Work

As the number of older adults with HIV/AIDS increases, new challenges are emerging that threaten their ability to age with this disease. Threats of particular concern are depression and suicidal ideation. Studies show that those aging with HIV/AIDS have a number of stressors that tax their coping mechanisms, increasing vulnerability to depression and suicidal ideation. These stressors can be categorized into three areas. First, there are psychosocial stressors that can contribute to depression. Second, there are health and biochemical stressors that can contribute to depression, as well as compromise cognitive abilities needed to adapt to such stressors. Third, cognitive stressors may create predispositions to depression. In particular, certain cognitive abilities needed to cope with depression and suicidal ideation may be compromised by aging with HIV/AIDS. A model of these stressors is provided for didactic purposes, as well as to suggest implications for social work practice and research.

Piloting an HIV Prevention Intervention for Cameroonian Girls

&NA; In this report, the authors describe the pilot test of a school‐based culturally tailored HIV prevention intervention for 10‐ to 12‐year‐old Cameroonian females. The aims of this research were to determine the feasibility of recruiting and enrolling Cameroonian girls in HIV prevention research studies, estimate the efficacy of the intervention, and assess cultural sensitivity of the intervention and study protocols. Sixty participants completed the study. A pre‐/posttest design was used to evaluate the intervention. Findings include 100% participation of all eligible participants with a majority (78%) of participants reporting positive perceptions of the intervention. The intervention was estimated to be potentially effective with significant increases in immediate postintervention sexual‐abstinence behavior skills (t = 4.51; p < .05) and intentions to postpone sexual activity (t = 3.40; p < .05). Findings can inform more rigorously designed studies of the intervention. This line of research can contribute to decreasing new infections among adolescents.

Correlates of Condom Self-Efficacy in an Incarcerated Juvenile Population

The purpose of this study was to enhance awareness of modes of HIV transmission and increase HIV/sexually transmitted diseases (STD) prevention efforts for incarcerated youth through use of an HIV/STD prevention program guided by the Making Proud Choices! curriculum. A convenience sample of 662 youth aged 13 to 18 was recruited from Alabama juvenile detention facilities. Participants took part in three 2-hour sessions. Baseline and postintervention data were collected. There was no significant difference between males and females in intent to use condoms at baseline and postintervention. Intent to use condoms was the most influential predictor of condom self-efficacy. However, there was little change in condom self-efficacy among males and females at baseline and postintervention.

Perceptions of Brain Health and Cognition in Older African Americans and Caucasians With HIV: A Focus Group Study

&NA; As people age with HIV, cognitive problems may become more prevalent and severe, but lifestyle behaviors (i.e., physical activity) have been shown to protect brain health and cognition. We examined the perceptions that older adults living with HIV have about protecting and improving brain health and cognition through lifestyle behaviors. Qualitative data were analyzed from four focus groups (N = 30) of African Americans and Caucasians living with HIV and at least 50 years of age. An open‐coding scheme using conventional content analysis was employed. Two results were found. First, many older adults with HIV in our study expressed a variety of cognitive complaints that interfered with daily function. Second, these participants reported few specific ideas about how such health behaviors were important to their own brain health and cognition. Education interventions may help older adults with HIV learn to improve and protect brain health and cognition as they age.