Pamela Valera

Race-Based Sexual Stereotyping and Sexual Partnering Among Men Who Use the Internet to Identify Other Men for Bareback Sex

This qualitative study used sexual scripting theory to explore sexual stereotyping and sexual partnering practices among a racially diverse sample of men who use the Internet to engage in “bareback” sex with other men. The sample included 81 (73%) HIV-negative and 30 (27%) HIV-positive men who were recruited on Web sites where men seek other men to have bareback sex. Participants completed a semi-structured interview that included topics on their racial identification, their sexual experiences tied to race, and their experiences having sex with men of different racial groups. The findings suggested that a variety of race-based sexual stereotypes were used by participants. Sexual stereotyping appeared to directly and indirectly affect the sexual partnering decisions of participants. Sexual scripts may reinforce and facilitate race-based sexual stereotyping, and this behavior may structure sexual networks.

‘‘Trying to Eat Healthy’’: A Photovoice Study About Women’s Access to Healthy Food in New York City

Photovoice is a participatory action approach in which individuals use photographs to identify and address issues in their community. The objective of this study was to document the challenges that low-income women face in accessing healthy food in New York city. Data were drawn from focus-group interviews with nine low-income women aged 20—45. The findings indicated that low-income women who live in homeless shelters have less access to healthy food, such as fresh fruits and vegetables, than do other women. They speak of the broader issue of structural barriers to eating healthy that women in impoverished urban communities face. Even with these constraints, women are not powerless and instead find ways to exercise personal agency.

Substance Use and HIV-Risk Behaviors Among Young Men Involved in the Criminal Justice System

Objectives: We examined the relationship between substance use and sexual HIV-risk behaviors among young men who have been incarcerated, in order to understand how HIV risks develop for this vulnerable population. Methods: A sample of 552 young men in a New York City jail was interviewed at the time of incarceration. Bivariate analyses were performed to examine demographic and sexual HIV-risk behavior differences between men with and without recent alcohol and marijuana use. Logistic regression was used to examine associations between alcohol and marijuana use and sexual HIV-risk behaviors in the 90 days prior to incarceration. Results: Respondents were predominantly Black (57%) or Latino (37%), with a mean age of 17.4 years. The most common substances used were marijuana (82%) and alcohol (65%). Alcohol use prior to incarceration was significantly associated with having three or more sexual partners in the same time period (OR = 2.40, p < .001), as well as with having unprotected sex with a long-term partner (OR = 1.72, p < .01). Marijuana use was significantly associated with having multiple sex partners (OR = 1.55, p < .01). Heavy alcohol and marijuana use did not result in an increased likelihood of sexual HIV-risk behaviors. Conclusions: High rates of substance use and unprotected sex may have unintended health consequences for incarcerated young men. Severity of substance use is not a significant predictor of risk behaviors, suggesting the importance of contextual and social factors. Results highlight the need for HIV prevention efforts for this population that take into account contextual and social factors.

Fear, Trust, and Negotiating Safety: HIV Risks for Black Female Defendants

Through in-depth interviews, this study examined the relational context of sexual HIV risk for 10 Black women aged 18—30 who were defendants in a community court setting. A qualitative data analysis identified themes of actual and feared intimate partner violence (IPV) and the expectations of demonstrating trust in a relationship as obstacles to negotiating the use of condoms. The findings speak to the broader structural factors and consequences of IPV and drug use. The article discusses the implications for HIV prevention for Black women who are involved in the criminal justice system.

Silences, Gestures, and Words: Nonverbal and Verbal Communication About HIV/AIDS and Condom Use in Black Heterosexual Relationships

This qualitative study examined how 27 Black men and women, ages 22 to 50 years, in heterosexual relationships communicated verbally and nonverbally about HIV/AIDS and condom use before first time sex. Although most interviewees reported no HIV/AIDS communication, most noted communication about condom use. Verbal condom communication focused typically on requests and declarations, whereas nonverbal communication centered on the presentation of condoms. Women were more likely to communicate about condoms verbally, whereas men were more likely to do so nonverbally. Interviewees who communicated about condom use were more likely than those who did not to report first-time condom use. We discuss these findings and their implications within the context of relationship and sociocultural factors relevant to HIV/AIDS in Black communities.

Contributions of Qualitative Research in Informing HIV/AIDS Interventions Targeting Black MSM in the United States

This article presents a systematic review of qualitative studies focusing on human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) among Black men who have sex with men (BMSM) in the United States. We reviewed studies that were published between 1980 and 2014. Qualitative methods employed in the studies reviewed include in-depth interviews, focus groups, participant observation, and ethnography. We searched several databases (PubMed, PsychINFO, JSTOR, ERIC, Sociological Abstracts, and Google Scholar) for relevant articles using the following broad terms: “Black men” “Black gay/bisexual” or “Black men who have sex with men,” and “qualitative” and/or “ethnography.” We include 70 studies in this review. The key themes observed across studies were (1) heterogeneity, (2) layered stigma and intersectionality, (3) risk behaviors, (4) mental health, (5) resilience, and (6) community engagement. The review suggests that sexual behavior and HIV-status disclosure, sexual risk taking, substance use, and psychological well-being were contextually situated. Interventions occurring at multiple levels and within multiple contexts are needed to reduce stigma within the Black community. Similarly, structural interventions targeting religious groups, schools, and health care systems are needed to improve the health outcomes among BMSM. Community engagement and using community-based participatory research methods may facilitate the development and implementation of culturally appropriate HIV/AIDS interventions targeting BMSM.

Risk factors for concurrent use of benzodiazepines and opioids among individuals under community corrections supervision.

BACKGROUND The use of heroin and prescription opioids has increased over the past decade. The concurrent use of opioids with other depressants such as benzodiazepines increases the risk of overdose death compared with use of either drug alone. This study examined factors associated with concurrent use of opioids and benzodiazepines in a criminal justice sample in the state of Alabama. METHODS The Addiction Severity Index (ASI) and urine drug screen results from 28,570 individuals who were under community corrections supervision from 2002-2012 were examined for independent or concurrent opioid and benzodiazepine use. Multinomial logistic regression analyses were conducted to determine associations between socio-demographic characteristics and drug use. RESULTS Concurrent use was detected in 11.5% of the sample. Concurrent use of opioids and benzodiazepines or use of either drug alone was associated with being White, female, married, prescribed psychiatric medications, having seen a physician in the past two years, cannabis use, and having a drug-related offense. Concurrent users were more likely to be unemployed or disabled and have received counseling, and less likely to have completed college, live with relatives or friends, have a history of hallucinations, or have an offense against a person relative to nonusers. DISCUSSION While significant overlap of risk factors exists between individuals with concurrent use versus sole use of opioids or benzodiazepines, individuals with concurrent use generally have more social dysfunction than individuals who tested for either substance alone. Concurrent users may need more psychosocial resources and intensive treatments to promote recovery.

Inclusion of Underserved Racial and Ethnic Groups in Cancer Intervention Research Using New Media: A Systematic Literature Review

BACKGROUND An increasing number of behavioral and psychosocial cancer interventions incorporate new media elements that are digital, networked, and interactive. However, it is unclear to what extent new media is being leveraged to benefit underserved racial and ethnic groups who disproportionately bear the burden of cancer. This inquiry is timely in light of growing evidence that these groups are receptive to new media. A systematic literature review was conducted to assess the inclusion of these groups in research on cancer-related new media interventions and use of new media to reduce racial and ethnic cancer disparities. METHODS A systematic search of three databases was conducted for articles published between January 2000 and March 2012 that presented studies of user experience with a behavioral or psychosocial cancer-related intervention with at least one new media component. RESULTS Thirty-six articles were included in the final review. In about one-quarter of the studies, less than 20% of participants were African American, Latino, Asian American, or American Indian. In less than 10% of the studies, 80% or more of the samples were members of the aforementioned groups. Almost one-third of the studies reviewed were categorized as disparity focused but limited data were available on racial and ethnic differences in responses to new media interventions. CONCLUSIONS Findings suggest that the promise and potential of new media cancer interventions are largely unrealized among the underserved. Additional research is needed to investigate a wide range of issues related to the development and delivery of such interventions in diverse racial and ethnic groups.

The illness narratives of men involved in the criminal justice system: A study of health behaviors, chronic conditions and HIV/AIDS.

Summary Former inmates encounter a variety of challenges when returning to their community, including poor health status and limited access to healthcare services. This qualitative study examined how former male inmates with chronic conditions perceived, understood, managed, and coped with their illnesses. Findings The participants were Black and Puerto Rican, with a mean age of 47 years, who were interviewed within three years of their release. Participants reported at least one chronic condition, with 21 HIV-negative men using chaos narratives to depict their approach to disease management. Nine HIV-positive men used quest narratives to present their illnesses and were immediately linked to supportive services, enabling them to overcome the barriers to community reintegration. Applications Health interventions in the area of forensic social work ought to focus on conducting Medicaid outreach and enrollment efforts prior to correctional facility discharge.

Exploring Kinship and Social Support in Women With Criminal Justice Backgrounds

Women’s incarceration has broad social impacts because of the unique caregiving roles that women occupy in their families and communities. In this study, we used qualitative interviews to examine kinship and social support among 30 women who had been recently released from incarceration in either a New York State prison or Rikers Island, New York City’s main jail complex. Qualitative findings suggest that women relied heavily on biological and extended family members for support. Kin relationships described were with other women (i.e., mothers, grandmothers, and female friends/peers), older female relatives were commonly described as caregivers, and caregiving was a key aspect of social support (both provided by and given to participants). Relationships with God were also important. Findings from this study contribute to our understanding of kin relationships and social support in women who have been incarcerated.