Karen Scheltema

Meta-analysis of the effectiveness of HIV prevention interventions for women

The present study is a meta-analysis of the effectiveness of HIV prevention interventions for women in the USA. Twenty-four articles from 1989-1997 were included. We evaluated five ethnic groupings (All Ethnicities Combined, African-American, White, Hispanic and a Mixed Ethnicity group) over four time periods (post-test, less than two months after the intervention, 2-3 months after the intervention and 6-24 months after the intervention) on three HIV-related sexuality outcome variables (HIV/AIDS knowledge, self-efficacy and sexual risk reduction behaviour). The HIV interventions appear effective at improving knowledge about HIV/AIDS and increasing sexual risk reduction behaviours for all ethnicities examined at all follow-up periods, with one exception. The findings for self-efficacy are less consistent. The interventions were less consistently effective for African-American women, for whom significant improvements in feelings of self-efficacy were only seen six months or longer after the intervention. The present analysis elucidates ethnic differences which may have previously been obscured while demonstrating convincingly that HIV interventions are generally effective for women of many different ethnicities.

Evaluation of a sexual health approach to reducing HIV/STD risk in the transgender community

Despite reports of high prevalence of human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) among the transgender community, very little prevention education has targeted this population. To fill this gap, we developed and evaluated a transgender-specific intervention, All Gender Health, which incorporates prevention strategies into comprehensive sexuality education. Transgender participants (N=181) attended the two-day seminar in community-based venues. The curriculum was delivered via lectures, panel discussions, videos, music, exercises and small group discussions. Attitudes toward condom use, safer sex self-efficacy and sexual risk behaviour were evaluated before participation in the intervention (pre-test), immediately after participation (post-test) and at three-month follow-up. Compared to pre-test values, significant improvements were seen in attitudes toward condom use and in safer sex self-efficacy at post-test, and in attitudes toward condom use, increased monogamy and decreased sexual risk behaviour at three-month follow-up. Pre-test data identified unprotected anal, vaginal and oral sex as the most commonly reported risk behaviours. Many respondents also indicated problems with social discrimination, depression, suicidal ideation and sexual functioning. Future interventions should address these risk co-factors. Alternative interventions need to be developed to target those who, as a result of social marginalization, are less likely to be reached with an intensive seminar-based intervention.

Risky sexual behavior in low‐income African American women: The impact of sexual health variables

In a sample of 163 low‐income African American women, we used logistic regression analyses to test for associations between (a) 5 operationalized constructs theorized in the Sexual Health Model to impact ones overall sexual health (barriers to healthy sexuality, sexual anatomy and functioning, positive sexuality, sexual health care, and cultural identity) and (b) several measures of risky sexual behavior (consistent condom use, multiple concurrent partnerships, and overall sexual risk). No significant relationship was found between acculturation and risky sexual behaviors. Having sexual difficulties was positively associated with overall sexual risk and multiple concurrent partnerships. Favorable attitudes toward condoms were positively associated with consistent condom use. Desiring or intending pregnancy was positively associated with inconsistent condom use and overall sexual risk behavior. This is only the second study linking sexual difficulties and risky sexual behavior. The exact nature of this correlational relationship needs to be studied and replicated in different and more heterogeneous populations.

Therapeutic uses of sexually explicit materials in the united states and the czech and slovak republics: A qualitative study

This study investigates the reflections of 279 U.S. and Czech and Slovak mental health and health professionals about their use of sexually explicit materials. Professionals were 2.6 times as likely to cite specific instances when their use of sexually explicit materials was useful with their clients and students than they were to cite instances when such materials were not useful. In addition, no significant differences were observed between the ways in which U.S. and Czech and Slovak mental health and health professionals evaluated these materials. The article presents several suggestions for the judicious and efficacious use of sexually explicit materials in therapy or in the classroom in either Western or Central European settings.

HIV/STD Knowledge, Attitudes, and Risk Behaviors in Hmong-American Adolescents: An Unstudied Population

This is the first study of HIV / STD knowledge, attitudes, and risk behaviors in the Hmong-American community. This exploratory study describes the self-reported HIV / STD knowledge, attitudes, and risk behaviors of 299 Hmong-American 7th - 12th grade students in nine public junior and senior high schools using bilingual questionnaires. Findings supported our hypotheses that Hmong-American adolescents had relatively low levels of risky behaviors, were significantly less likely to answer HIV / STD culturally specific knowledge and attitude items correctly than general knowledge and attitude items, and that their level of acculturation was positively related to their HIV / STD knowledge and attitudes. In addition, we found that Hmong-American adolescents had higher levels of knowledge about HIV/STD and more desirable attitudes toward HIV / STD than originally predicted. Finally, we found that the age, grade, sex, and marital status of the Hmong adolescents in our study were significantly related to either t...

Erratum: Patient satisfaction with transgender health services (Journal of Sex and Marital Therapy (2004) 30:4 (277-294))

In the article “Precision of Higher-Order Aberration Measurements with a New Placido-disk Topographer and Hartmann-Shack Wavefront Sensor” (J Cataract Refract Surg 2013; 39:242–249), the intrasession Sw values given in the “Intrasession Repeatability” section (page 244) were incorrect. The fifth sentence in that section should say, “For the spherical and astigmatic component of the autorefraction, the intrasession Sw values were 0.20 D and 0.13 D, respectively, and the precision values were 0.40 D and 0.26 D, respectively.”