Kami A. Kosenko

Contextual influences on sexual risk-taking in the transgender community.

High HIV prevalence and incidence rates and high-risk sexual activity have been documented in certain subgroups of the transgender community; however, less is known about the sexual experiences and risks shared by these subgroups. To identify contextual features influencing the sexual risk-taking of transgender adults, semi-structured interviews conducted with 41 self-identified transgender adults were analyzed via constant comparative analysis, a technique rooted in grounded theory. Seven aspects of the transgender experience, including stigma, financial hardship, sexual objectification, a lack of outreach, hormones, a second puberty, and gender role issues, created a unique context of risk. Findings indicate that traditional HIV prevention efforts might not be suited to the unique needs of transgender adults. Tailoring HIV prevention efforts to this community will warrant further attention to contextual influences on sexual risk and safety.

Uncertain Terms: Message Features of Online Cancer News

About 113 million Americans have reported seeking health information online; however, little is known about the quality (or qualities) of the information being retrieved. Users have reported seeking information about health issues in an attempt to reduce negatively appraised uncertainties (Brashers, 2007), but less is known about the ability of the retrieved information to increase or produce unwanted uncertainty. A content analysis of online cancer news was conducted and suggests that 65% of Internet-based cancer news contains message features previously linked to the production of uncertainty (e.g., ambiguous or complex information). Though future research is required regarding uncertainty-related content and its effects, this project provides a foundation for such future endeavors.

Celebrity Influence and Identification: A Test of the Angelina Effect

Angelina Jolies announcement that she is a BRCA1 carrier and has had a prophylactic bilateral mastectomy was met with widespread support as well as speculation about its possible impact on the public. These speculations were the subject of a Time magazine cover story titled “The Angelina Effect” (Kluger et al., 2013). Although there is anecdotal evidence to support this hypothesized Angelina effect, empirical tests are lacking. To explore possible links between Angelinas announcement and public health, we surveyed 356 adults immediately after the announcement. Guided by a model of celebrity influence, the survey assessed participants’ demographics and health history, identification and parasocial interaction with Jolie, and genetic testing intentions. Results supported the models predictions and provided preliminary evidence of an Angelina effect.

Meanings and dilemmas of sexual safety and communication for transgender individuals.

HIV prevention efforts stress interpersonal communication skills and their protective benefits; however, research on sexual communication has lagged behind interventions that emphasize communication. This project was undertaken to determine how sex talk unfolds in a specific relational and sociocultural context--the transgender community—as well as what constitutes effective or satisfying safer sex talk. Goldsmiths normative theory guided semistructured interviews with 41 transgender individuals. Transgender participants held multiple, often competing goals in safer sex conversations, which resulted in communicative dilemmas. Creative management strategies allowed participants to achieve desired outcomes, like safer sex, without threatening identities and relationships. Implications for communication and health behavior theory and practice are discussed in light of these findings.

An Exploration Into the Uses and Gratifications of Media for Transgender Individuals.

Transgender individuals, those whose gender presentation diverges from their biological sex, encounter unique obstacles to identity development and socialization. The present study examines how transgender individuals use both traditional and emerging media to better understand their own gender identities and their social worlds. A constructivist approach to the uses and gratifications perspective motivated interview questions about the role of media in the lives of transgender individuals. Forty-one transgender individuals participated in semistructured interviews. Results suggested media were instrumental for sensemaking. Participants used media to make sense of feelings, sexual relations, community, and transition options. Participants also used media to meet nonmediated goals or to initiate interpersonal negotiations. The potential impact of media on transgender audiences and the limitations of the uses and gratifications perspective are discussed in light of the findings.

The Information Management Processes of Women Living with HPV

The human papillomavirus (HPV) represents a significant public health burden because of its widespread prevalence, its links to genital warts and cancers, and the negative psychosocial impact of HPV infection and diagnosis. Scholars have attributed some of these negative effects to insufficient knowledge and information about HPV, prompting research on womens HPV information preferences; however, little is known about how women obtain, avoid, and use this information. To address this lacuna, we designed a study to trace the information management processes of women with HPV. Our analysis of interviews with 25 women living with HPV revealed a common sequence of emotional, cognitive, and behavioral responses to the HPV diagnosis. The authors review these findings and articulate their relevance and importance to research, theory, and practice in the discussion.

“I Survived”: The Content and Forms of Survival Narratives

Individuals impacted by violent crime are at risk for posttraumatic stress disorder and other comorbid conditions. Screening and early intervention are key to the detection and treatment of these consequences of victimization. A growing literature points to the diagnostic power of narratives; however, little is known about the narratives produced by survivors. This study assessed the content and forms of narratives told by survivors of violent crime. In our sample, narratives of growth and optimism, grief and loss, providence, self-reliance, and justice were common. These narratives also featured common lexical properties. The discussion articulates possible explanations for these findings.

Diagnosing women with HPV: The impact of diagnosis disclosure methods

OBJECTIVE Little data exists on womens HPV diagnosis encounters. This research focuses on impacts of the communicative medium used to inform women of their HPV status. We conducted a qualitative study to identify the mediums used to communicate HPV diagnoses and the impact of each medium on the diagnosis experience. METHOD Twenty-five women with HPV completed semi-structured interviews, which we recorded and transcribed. We relied on grounded theory techniques in both data collection and analysis. RESULTS There are three primary mediums health care providers use to inform women of their HPV diagnosis: phone calls, mailed letters/email, and face-to-face interactions. Implications regarding each medium are identified and discussed. CONCLUSION There are drawbacks associated with the use of each medium that healthcare practitioners should be aware of and seek to avoid. PRACTICE IMPLICATIONS Healthcare providers can utilize descriptions of diagnosis encounters and the recommendations accompanying them to understand and modify ways they choose to inform individuals of an HPV diagnosis.

What Facilitates the Wait? Lessons Learned from Successful Sexual Abstainers

Religious individuals are more likely than their secular counterparts to abstain, but the explanatory mechanisms for religion’s salutary effects on sexual and other health behaviors are poorly understood. Given that social support and other communicative processes are likely explanations for the religion–abstinence connection, this study was designed to determine what communication processes facilitate the wait for religious individuals. Interviews with 23 abstainers revealed that certain communication practices, such as avoiding temptations, creating networks of like-minded individuals, engaging in communal coping, establishing boundaries, finding role models, making social comparisons, and adhering to and enforcing injunctive norms enabled abstinence.

Helpful and Challenging Support Encounters in the Aftermath of HPV Infection and Diagnosis

Infection and diagnosis with HPV create significant support needs, yet the support experiences and evaluations of women with HPV remain unexplored. This study identified supportive communication behavior perceived as helpful or problematic by women with HPV. Interviews with 25 participants revealed that women find it helpful when supportive others: (a) provide reassurance, information, and validation; (b) attend appointments; (c) facilitate reappraisals; and, (d) listen. Findings also highlighted support challenges, such as disclosure difficulties and problems locating and accessing support groups. The discussion focuses on explanations for and implications of variations in enacted support quality for women with HPV and others managing chronic illnesses.