Larry M. Gant

A socially contextualized model of African American identity: Possible selves and school persistence.

Schooling, critical to the transition to adulthood, is particularly problematic for urban and minority youths. To explore predictors of school persistence the authors propose a socially contextualized model of the self. Strategies to attain achievement-related possible selves were differentially predicted for White and Black university students (Study I, n = 105). For Whites, individualism, the Protestant work ethic, and balance in possible selves predicted generation of more achievement-related strategies. For Blacks, collectivism, ethnic identity, and low endorsement of individualism tended to predict strategy generation. In middle school, performance was predicted by gendered African American identity schema, particularly for females (Study 2, n = 146), and the effects of social context appeared gendered (Study 3, n = 55). Balance in achievement-related possible selves predicted school achievement, especially for African American males ( Study 4, n = 55).

Pervasive exposure to violence and posttraumatic stress disorder in a predominantly African American Urban Community: The Detroit neighborhood health study

Exposure to traumatic events is common, particularly among economically disadvantaged, urban African Americans. There is, however, scant data on the psychological consequences of exposure to traumatic events in this group. We assessed experience with traumatic events and posttraumatic stress disorder (PTSD) among 1,306 randomly selected, African American residents of Detroit. Lifetime prevalence of exposure to at least 1 traumatic event was 87.2% (assault = 51.0%). African Americans from Detroit have a relatively high burden of PTSD; 17.1% of those who experienced a traumatic event met criteria for probable lifetime PTSD. Assaultive violence is pervasive and is more likely to be associated with subsequent PTSD than other types of events. Further efforts to prevent violence and increase access to mental health treatment could reduce the mental health burden in economically disadvantaged urban areas.

The Intersection of Gender and Ethnicity in HIV Risk, Interventions, and Prevention: New Frontiers for Psychology.

This article articulates a contextualized understanding of gender and ethnicity as interacting social determinants of HIV risk and acquisition, with special focus on African Americans and Hispanics/Latinos--2 ethnic groups currently at most risk for HIV/AIDS acquisition in the United States. First, sex and gender are defined. Second, a conceptual model of gender, ethnicity, and HIV risk and resilience is presented. Third, a historical backdrop of gender and ethnic disparities is provided, with attention to key moments in history when notions of the intersections between gender, ethnicity, and HIV have taken important shifts. Finally, new frontiers in psychology are presented, with recommendations as to how psychology as a discipline can better incorporate considerations of gender and ethnicity as not only HIV risk factors but also as potential avenues of resilience in ethnic families and communities. Throughout the article, we promulgate the notion of a syndemic intersectional approach, which provides a critical framework for understanding and building the conditions that create and sustain overall community health by locating gendered lived experiences and expectations within the layered conceptual model ranging from the biological self to broader societal structures that define and constrain personal decisions, behaviors, actions, resources, and consequences. For ethnic individuals and populations, health disparities, stress and depression, substance abuse, and violence and trauma are of considerable concern, especially with regard to HIV risk, infection, and treatment. The conceptual model poses new frontiers for psychology in HIV policy, research, interventions, and training.

Early Motherhood, High Mortality, and HIV/AIDS Rates in Sub-Saharan Africa

Despite billions of dollars devoted to HIV/AIDS prevention since 1990, rates of infection continue to climb worldwide, primarily through heterosexual contact, and Sub-Saharan Africa is the worst case scenario (UNAIDS, 2004). Traditional intervention programs based on the ABCs (abstinence, being faithful, and condom use) of safe sex practices have shown mixed success. Engaging in risky sexual behavior (behaviors not adhering to the ABCs of safe sex practices) continues to escalate the HIV/AIDS epidemic. Although research abounds with correlates to HIV/AIDS rates, few studies have addressed the basis of sexual behavior. Here we show that not only are HIV/AIDS rates significantly higher in Sub-Saharan Africa than in the rest of the world but also infant mortality rates and teenage birth rates are higher as well. Based on these findings, we argue that engaging in risky sexual behavior, in many circumstances associated with deplorable living conditions and high mortality, is the only viable option for avoiding reproductive failure: dying without leaving surviving descendents. We suggest that initiatives that improve overall health and living conditions in the at-risk populations are necessary before traditional intervention programs can effectively combat the spread of HIV/AIDS in Sub-Saharan Africa.

INCORPORATING INTEGRATIVE HEALTH SERVICES IN SOCIAL WORK EDUCATION

More than one third of Americans practice complementary and alternative medicine (CAM). Social workers continue to provide most first-line health, mental health, and psychological referral and direct practice services in the United States, despite a lack of systematic education and training opportunities in CAM. Schools of social work are appropriate venues for providing regular and continuing educational opportunities. The gap between education and practice can be addressed in social work curricula by (1) addressing integrative health from a general systems perspective, (2) reaffirming the role of social workers in health care, and (3) providing opportunities to develop competence with a simple yet conceptually integrated CAM-based skill set. Several content approaches and suggestions for curricula deployment are provided, including stand-alone courses, curricular infusion strategies across core areas of social work education, and location of curricular homes across college and university departments.

Associations Between HIV Risk, Unmitigated Communion, and Relationship Power Among African American Women

Most new HIV infections among African American women are due to unprotected sex in heterosexual relationships. Womens scores on measures of relationship power and unmitigated communion (focus on others and exclusion of self) are associated with risky sexual behavior. We hypothesized African American women scoring low on relationship power and high on unmitigated communion would report greater risk for HIV infection. In a sample of 217 African American adult women, relationship power strongly correlated with HIV risk (p < .05), but unmitigated communion did not. Relationship power explained 40% of the variance in womens perceived HIV risk (β = −.631, p = .000). Compared to their high relationship power counterparts, African American women with low to moderate levels of relationship power were 5 to 40 times less likely to successfully negotiate condom use and only reduced their HIV risk by 5% to 20% (compared to 80% to 95% improvements in risk reduction by their high relationship power counterparts).

A Census Tract–Level Examination of Social Determinants of Health among Black/African American Men with Diagnosed HIV Infection, 2005–2009—17 US Areas

Background HIV disproportionately affects black men in the United States: most diagnoses are for black gay, bisexual, and other men who have sex with men (collectively referred to as MSM). A better understanding of the social conditions in which black men live and work may better explain why HIV incidence and diagnosis rates are higher than expected in this population. Methods Using data from the National HIV Surveillance System and the US Census Bureaus American Community Survey, we examined the relationships of HIV diagnosis rates and 5 census tract–level social determinants of health variables for 21,948 black MSM and non-MSM aged ≥15 years residing in 17 areas in the United States. We examined federal poverty status, marital status, education level, employment status, and vacancy status and computed rate ratios (RRs) and prevalence odds ratios (PORs), using logistic regression with zero-inflated negative binomial modeling. Results Among black MSM, HIV diagnosis rates decreased as poverty increased (RR: 0.54). At the time of HIV diagnosis, black MSM were less likely than black non-MSM to live in census tracts with a higher proportion below the poverty level (POR: 0.81) and with a higher proportion of vacant houses (POR: 0.86). In comparison, housing vacancy was positively associated with HIV diagnosis rates among black non-MSM (RR: 1.65). HIV diagnosis rates were higher for black MSM (RR: 2.75) and non-MSM (RR: 4.90) whose educational level was low. Rates were significantly lower for black MSM (RR: 0.06) and non-MSM (RR: 0.26) as the proportion unemployed and the proportion married increased. Conclusions This exploratory study found differences in the patterns of HIV diagnosis rates for black MSM and non-MSM and provides insight into the transmission of HIV infection in areas that reflect substantial disadvantage in education, housing, employment, and income.

Community Organization in the Twenty-First Century: Scholarship and Practice Directions for the Future

The context for community practice in social work is continually changing. As we entered the 21st century, we would not have envisioned the challenges and opportunities that exist today in our nation and the world. In 2000, most would not have predicted the degree to which global and domestic terrorism, economic adjustments, natural disasters, migration and immigration, new and emerging technologies, globalization, and other phenomena would impact the structure and substance of our lives. These conditions have affected everyone, but they have taken a significant toll on the lives of those who are most vulnerable. These challenges are not unique to the United States and are mirrored around the globe. What is the role of community practice in social work in this environment? Immigration and fertility patterns over the past 30 years have led to an increasingly multiracial, multicultural, and multiethnic society. At the same time, conditions of economic inequality and economic stratification by gender and race have not abated. These trends in the substance and structure of our society challenge our field to evaluate how it can best address these demographic shifts. One critical question is how we can develop knowledge, practice, policies and research that will contribute to social justice in an increasingly multicultural world. These questions were the focus of the Symposium on Interdisciplinary Scholarship for Community Organization in the 21st Century, held in June 2012 at the University of Michigan’s School of Social Work. The symposium was organized by the Community Organizing Learning Community at the

Substance Use, Emerging Adults, and HIV Services in the Third Decade

In the third decade of HIV=AIDS, substance use continues to be a risk factor for HIV infection, particularly for youth found in the intersections of mental health programs and court adjudicated services. Youth who are in hard-toreach or hard-to-access subcultures (e.g., house and ball communities) are as hard to access by generic universal test-and-treat programs as are youth who do not fit a particular at-risk category. Thus, preventive approaches remain important strategies for hard-to-access and hard-to-reach populations in all communities. The articles in this issue provide accounts of programs that provide the third plank of HIV reduction in the United States. In ‘‘Drug Treatment Utilization Among Illicit Drug Users Receiving HIV Prevention Services in Los Angeles County,’’ Brocato’s team found data underscoring the importance of HIV=AIDS prevention services in facilitating a triangulated integration of substance use treatment, HIV prevention, and sexual health services that reduces the incidence of HIV among drug-using populations. The study reflects the importance of evaluating integrated service models with monitoring, oversight, assessment, and appraisal. Traube and colleagues explore ‘‘Illicit Substance Use Among Emerging Adults in the Los Angeles House and Ball Community.’’ Drug use for adolescent members of Los Angeles house=ball communities remains higher than comparative norms. However, membership in these communities appears to provide double benefits from the social support of the house=ball community and protection within their academic community. In ‘‘Make It Like the Real World: Adolescents’ Recommendations for the Design of a Digital HIV Prevention Game,’’ Enah and colleagues report findings from youth responses to the development of an existing online HIV prevention game. Major categories of recommendations from study participants for the content and design of the game included allowing for player control in gaming features, including virtual monetary reward systems, and using real-world scenarios or missions in the game. Building on participants’ recommendations will contribute to the development of a contextually and culturally relevant game that could be predictably effective in reducing health disparities experienced by adolescents. Auslander’s study group reports on ‘‘The Moderating Effect of Marijuana Use on the Relationship Between Delinquent Behavior and HIV Risk Among Journal of HIV/AIDS & Social Services, 13:123–124, 2014 Copyright # Taylor & Francis Group, LLC ISSN: 1538-1501 print=1538-151X online DOI: 10.1080/15381501.2014.909632

Using the Miracle Question in Community Engagement and Planning

Actively engaging community members in the revitalization of their neighborhoods is a goal of numerous planning initiatives. In this article, we provide a case example of how the solution-focused brief therapys “miracle question” was used to engage members of a major metropolitan community in visualizing their dreams and planning strategies for change. Similar to outcomes with therapy clients, community members participated actively and were enthusiastic in communicating their outcomes. Dreams were realistic and important to participants, and suggested strategies were oriented toward first steps and recognized as involving effort by the community. Engagement and retention were sufficient to move forward with immediate actions and longer-term preparation. Benefits and suggested modifications are offered for community practitioners and researchers employing this method.