Katie E. Mosack

The role of family and friend social support in reducing emotional distress among HIV-positive women.

The purpose of this study was to examine HIV-positive women regarding their perceptions of family and friend social support and mental health outcomes. Regression models were constructed for five mental health outcomes. Results indicated that while each outcome has slightly different significant predictors, perceived family support was predictive of the reduced loneliness over the past few days and past year, stress, and presence of depressive symptoms. Implications for researchers and therapists are discussed.

Microbicide Acceptability Among High-Risk Urban U.S. Women: Experiences and Perceptions of Sexually Transmitted HIV Prevention

Objectives: The objectives of this study were to measure microbicide acceptability among high-risk women in Hartford, Connecticut, and contextual factors likely to affect acceptability and use. Goal: The goal of this study was to assess usefulness of microbicides for HIV/sexually transmitted infection (STI) prevention for high-risk women. Study: Ethnographic interviews (n = 75) and a survey (n = 471) explored women’s perspectives on HIV/STI prevention, vaginal contraceptives similar to microbicides, and microbicide acceptability. Participants (n = 94) in a 2-week behavioral trial used an over-the-counter vaginal moisturizer to simulate microbicide use during sex with primary, casual, and/or paying partners. Results: Findings showed limited experience with vaginal contraceptives, but high interest in microbicides as an alternative to condoms, indicated by an acceptability index score of 2.73 (standard deviation, 0.49; scale of 1–4) in the overall sample. General microbicide acceptability varied by ethnicity, prior contraceptive and violence/abuse experiences, relationship power, and other attitudinal factors. The simulation trial indicated significant willingness to use the product in various locations and with all types of partners. Conclusions: Vaginal microbicides may improve prevention outcomes for high-risk inner-city women.

If I Didn’t Have HIV, I’d Be Dead Now: Illness Narratives of Drug Users Living With HIV/AIDS

The purpose of this study is to illuminate the experiences of lower income, urban, HIV-positive drug users. The authors asked 60 participants about HIV risk behaviors, the impact of HIV on their lives, religious beliefs, life plans, relationships, and work-related issues both prior to and since diagnosis. They developed a theoretical framework based on illness narratives and ambiguous loss theories. Themes pertaining to both physical and emotional or spiritual dimensions were located within Benefit, Loss, or Status Quo orientations. The findings contribute to researchers’ understanding of the HIV/AIDS illness experiences among the very marginalized and have important implications for physical and mental health care professionals working with HIV-positive drug users.

Sexual risk-taking among high-risk urban women with and without histories of childhood sexual abuse: mediating effects of contextual factors.

This study investigated the mechanisms of risk for urban women at high risk for HIV with and without childhood sexual abuse histories. Childhood sexual abuse survivors reported more unprotected intercourse and sexually transmitted infections (STIs). The association of STI locus of control with frequency of unprotected sex was fully mediated by being intoxicated during sex and engaging in sex work, whereas the association between relational control and unprotected sex was not mediated by contextual factors for the childhood sexual abuse group. The mechanisms of risk are different for those with divergent childhood sexual abuse histories and thus interventions should be developed to educate women with a history of childhood sexual abuse about ways to avoid revictimization, particularly within a context of poverty, prostitution, and drug use.

The Risk Avoidance Partnership: Training Active Drug Users as Peer Health Advocates:

Efforts have expanded to create AIDS prevention programs for drug users that consider the social context and interpersonal relationships within which risky practices take place. The Risk Avoidance Partnership (RAP) project is designed to train active drug users as peer/public health advocates (PHAs) to bring a structured, peer-led intervention into the sites where they and their drug-using social networks use illicit drugs. The RAP peer health advocacy training curriculum and peer-led intervention promote harm reduction among drug users and support drug-user organization to reduce infectious disease and other harm in the context of injection drug use, crack cocaine use, and sexual activity. Initial findings suggest that RAP PHAs perceive a significant positive role change in themselves while conducting health advocacy work and willingly and successfully carry the peer-led intervention into locations of high-risk drug activity to deliver it to their peers even in the absence of project staff support.

Influence of coping, social support, and depression on subjective health status among HIV-positive adults with different sexual identities.

The authors examined associations between psychosocial variables (coping self-efficacy, social support, and cognitive depression) and subjective health status among a large national sample (N = 3,670) of human immunodeficiency virus (HIV)-positive persons with different sexual identities. After controlling for ethnicity, heterosexual men reported fewer symptoms than did either bisexual or gay men and heterosexual women reported fewer symptoms than did bisexual women. Heterosexual and bisexual women reported greater symptom intrusiveness than did heterosexual or gay men. Coping self-efficacy and cognitive depression independently explained symptom reports and symptom intrusiveness for heterosexual, gay, and bisexual men. Coping self-efficacy and cognitive depression explained symptom intrusiveness among heterosexual women. Cognitive depression significantly contributed to the number of symptom reports for heterosexual and bisexual women and to symptom intrusiveness for lesbian and bisexual women. Individuals likely experience HIV differently on the basis of sociocultural realities associated with sexual identity. Further, symptom intrusiveness may be a more sensitive measure of subjective health status for these groups.

Acceptability of hypothetical microbicides among women in sex establishments in rural areas in southern China.

Objectives and Goal: The objectives of this study were to measure the potential acceptability of a hypothetical microbicide among women in sex establishments in rural areas of Southern China and demographic, behavioral, and social context factors likely to affect microbicide acceptability. Study Design: This was a cross-sectional survey, using a quota sampling, among 300 women from sex establishments in 3 rural towns. An interviewer-administered standardized questionnaire was used to measure the acceptability score of hypothetical microbicides’ characteristics, as well as sexual relationships and behaviors and other contextual factors. Results: Findings showed a generally positive response to microbicides, indicated by an acceptability index score of 2.89 (SD, 0.56, scale of 1–4) in the overall sample. Multivariate analysis shows that the acceptability score varied significantly by study sites, type of sex-work establishments, marital status, sex partner type, vaginal product experience, locus of control by partners, and locus of control by chance. Conclusions: Microbicides may be acceptable among sex workers in rural settings in China; however, contextual factors should be carefully considered in education and promotion of microbicides in the future.

Veterans service organization engagement in ‘POWER,’ a peer-led hypertension intervention

Objectives: The purpose of this study was to determine the influence of program factors on participant engagement in POWER, a peer-led intervention designed to reduce hypertension, increase hypertension knowledge, and improve other relevant health behaviors, such as diet and exercise, among US veterans involved in veterans service organizations throughout Southeastern Wisconsin. Methods: Two hundred and nineteen hypertensive members from 58 VSOs participated in a year-long peer-led intervention designed to improve hypertension knowledge, disease self-management behaviors, and health outcomes. This study represents a qualitative evaluation of post and participant engagement in this intervention. We triangulated data collected via three qualitative approaches (observations, focus groups, and in-depth interviews) from intervention posts to derive a model of engagement. Results: Our findings indicate that discrete characteristics of the peer leaders, post members, posts, and the intervention itself contributed to intervention engagement. Discussion: We make suggestions for future research studies, particularly as related to understanding how peer leader identities and cultural norms within VSOs might contribute to peer-led health intervention success.

Expanding the theory of planned behavior to predict healthy eating behaviors

Purpose – This paper aims to test whether overall and specific healthy eating behaviors and intentions could be better predicted by expanding the theory of planned behavior (TPB) to include a healthy eater identity. Major health organizations suggest increasing consumption of fruits, vegetables and whole grains to address the growing number of overweight and obese individuals, yet researchers have questioned the degree to which existing behavioral intervention programs sufficiently explain healthy eating behaviors. Design/methodology/approach – Adult women (N = 79) completed questionnaires related to TPB components and healthy eater identity. Participants then recorded food consumption for four days using food diaries and food frequency questionnaires. Findings – Using hierarchical multiple regressions, the authors demonstrated that identity as a healthy eater was a significant predictor of healthy eating intentions beyond the TPB components and a significant predictor of fruit and low-fat dairy consumpti...

Individual, peer, and family variables associated with risky sexual behavior among male and female incarcerated adolescents

Abstract This study examined individual, peer, and family variables associated with adolescent sexual risk behavior. Participants included 1008 adolescents (857 males and 151 females) incarcerated in Virginia juvenile correctional facilities. At the bivariate level, externalizing behaviors, social problems, perceived friend support, perceived family support, and family structure were significantly correlated (p < .10) with the lifetime number of sexual partners. After controlling age, multivariate analyses found that externalizing behaviors, social problems, perceptions of better family support, and family structure were significantly associated with the lifetime number of sexual partners for the full sample (p < .01) and males (p < .01). For females, externalizing behaviors and social problems were significantly associated with lifetime number of sexual partners (p < .01). These findings support the need to consider social influences on sexual risk-taking among adolescents. Intervention efforts aimed at reducing risk behavior among adolescents should be gender specific and focus on developing effective coping behaviors and bolstering social support, particularly within family systems.