Rita M. Melendez

Gender Nonconformity, Homophobia, and Mental Distress in Latino Gay and Bisexual Men

This study explored whether gender nonconformity in gay and bisexual men is related to mental distress and if so, whether this relationship is mediated by negative experiences that are likely associated with gender nonconformity, including abuse and harassment. To study this question, data were analyzed from face-to face interviews with 912 self-identified gay and bisexual Latino men in three major U.S. cities collected by Diaz and colleagues (2001). Gay and bisexual Latino men who considered themselves to be effeminate had higher levels of mental distress and more frequently reported various negative experiences, compared with gay and bisexual Latino men who did not identify as effeminate. Higher levels of mental distress in effeminate men seemed to primarily result from more experiences of homophobia. Findings suggest the need for more attention to gender in research as well as counseling of sexual minority men.

‘It's really a hard life’: Love, gender and HIV risk among male‐to‐female transgender persons

Scientific studies demonstrate high rates of HIV infection among male‐to‐female (MTF) transgender individuals and that stigma and discrimination place MTFs at increased risk for infection. However, there is little research examining how gender roles contribute to HIV risk. This paper reports on in‐depth interviews with 20 MTFs attending a community clinic. Data reveal that stigma and discrimination create a heightened need for MTFs to feel safe and loved by a male companion and that in turn places them at a higher risk for acquiring HIV. Male‐to‐female transgender individuals appear to turn to men to feel loved and affirmed as women; their main HIV risk stems from their willingness to engage with sexual partners who provide a sense of love and acceptance but who also may also request unsafe sexual behaviours. A model illustrating how HIV risk is generated from stigma and discrimination is presented.

Intimate Partner Violence and HIV/STD Risk Among Lesbian, Gay, Bisexual, and Transgender Individuals

To date, there has been little research examining HIV/STD risk among lesbian, gay, bisexual, and transgender (LGBT) individuals who are in abusive relationships. This article uses data collected from a community-based organization that provides counseling for LGBT victims of intimate partner violence (IPV). A total of 58 clients completed the survey, which inquired as to sexual violence and difficulties negotiating safer sex with their abusive partners. A large percentage of participants reported being forced by their partners to have sex (41%). Many stated that they felt unsafe to ask their abusive partners to use safer sex protection or that they feared their partners’ response to safer sex (28%). In addition, many participants experienced sexual (19%), physical (21%), and/or verbal abuse (32%) as a direct consequence of asking their partner to use safer sex protection. Training counselors on issues of sexuality and safer sex will benefit victims of IPV.

Intimate Partner Violence and Safer Sex Negotiation: Effects of a Gender-Specific Intervention

This study examined the effects of a gender-specific HIV/STD prevention intervention with two dosage levels (four-session, eight-session) among women reporting physical abuse by a current or recent (past year) intimate partner. From 360 women included in the full randomized trial, we conducted subgroup analyses among 152 women who experienced partner physical abuse within the past year. Unprotected vaginal and anal sex occasions and negotiation skills were examined as outcomes. We also assessed whether the intervention increased previously abused womens subsequent risk of physical abuse. Among abused women, those in the eight-session, but not the four-session, intervention decreased their unprotected sex occasions or maintained consistent safer sex at both 1-month (OR = 3.63, 95% CI = 1.50–8.80) and 1-year (OR = 2.88, 95% CI = 1.17–7.10) postintervention. In the short-term, abused women in both the four- and eight-session groups had a greater odds of using an alternative strategy (e.g., refusal, “outercourse,” or mutual testing) and of having a safer sex discussion with their partners relative to their controls, and they scored higher on intention to negotiate safer sex. The intervention did not increase or decrease the incidence of subsequent abuse during the 1-year follow-up period. A gender-specific intervention that focuses on negotiation skills in the context of potentially abusive partners benefits, and does not appear to harm, recently abused women.

Male-to-Female Transgender Individuals Building Social Support and Capital From Within a Gender-Focused Network

ABSTRACT The literature on male-to-female transgender myriad problems such individuals face in their day-to-day lives, including high rates of HIV/AIDS, addiction to drugs, violence, and lack of health care. These problems are exacerbated for ethnic and racial minority MTFs. Support available from their social networks can help MTFs alleviate these problems. This article explores how minority MTFs, specifically in an urban environment, develop supportive social networks defined by their gender and sexual identities. Using principles of community-based participatory research (CBPR), 20 African American and Latina MTFs were recruited at a community-based health care clinic. Their ages ranged from 18 to 53. Data were coded and analyzed following standard procedure for content analysis. The qualitative interviews revealed that participants formed their gender and sexual identities over time, developed gender-focused social networks based in the clinic from which they receive services, and engaged in social capital building and political action. Implications for using CBPR in research with MTFs are discussed.

Health and Health Care Among Male-to-Female Transgender Persons Who Are HIV Positive

Recent studies have reported high rates of HIV infection among male-to-female transgender persons, but little research has examined how male-to-female transgender persons manage living with HIV. We compared demographic and health characteristics of 59 male-to-female transgender persons who were HIV positive with 300 nontransgender control subjects who were HIV positive. We found several demographic differences between the groups but no significant differences in HIV-related health status. Male-to-female transgender persons were less likely than the control group to take highly active antiretroviral therapy.

HIV prevention and primary care for transgender women in a community-based clinic.

&NA; Male‐to‐female transgender individuals, or transgender women (TW), are at high risk for HIV infection and face multiple barriers to HIV care. Advocates agree that numerous factors need to be addressed concurrently to prevent HIV infection in TW, including primary health care. This article examines how a community‐based clinic that offers free or low‐cost care addresses the health care needs of TW. A total of 20 TW who attended a health care clinic dedicated to community‐based health were interviewed regarding best practices for HIV prevention and primary care. In‐depth interviews were conducted, transcribed, coded, and analyzed. Factors reported to be effective for HIV prevention and primary care included (a) access to health care in settings not dedicated to serving transgender and/or gay communities, (b) a friendly atmosphere and staff sensitivity, and (c) holistic care including hormone therapy. Community‐based health care settings can be ideal locales for HIV prevention and primary care for TW.

Revisiting “Success”: Posttrial Analysis of a Gender-Specific HIV/STD Prevention Intervention

Alongside the recognized need to foster the development of innovative gender-specific HIV interventions, researchers face the urgent need to further understand how current interventions do or do not work. Few studies build posttrial qualitative analysis into standardized interview assessments in randomized controlled trials in order to bolster an assessment of how interventions work. The current investigation is a posttrial qualitative analysis carried out on a randomly selected subsample (N=180), representing 50% of women who participated in a 3-arm randomized controlled trial known as Project FIO (The Future Is Ours). FIO was a gender-specific HIV prevention intervention carried out with heterosexually active women in a high seroprevalence area of New York City. Posttrial qualitative results extend an understanding of the success of the trial (e.g., reductions in unsafe sex). Qualitative results reflect how the Modified AIDS Risk Reduction Model operated in the expected direction across experimental groups. Results also highlight womens empowerment narratives, reflecting the salience of bodily and sexual rights aspects of the intervention.

The Female Condom: Attitudes and Experiences Among HIV-Positive Heterosexual Women and Men

ABSTRACT The female condom is a potentially effective method for the prevention of HIV, other sexually transmitted disease, and pregnancy. This study describes attitudes toward and experiences with the female condom of 89 HIV-positive individuals (n = 56 women; n = 33 men) reporting heterosexual behavior. Qualitative interviews were conducted to inform the design and implementation of a cognitive-behavioral risk-reduction and health-promotion intervention. Most respondents (n = 78) had seen or heard of the female condom. However, relatively few (n = 14 women; n = 5 men) had used it at least once. Reactions from both women and men across user groups, regardless of favorable or unfavorable attitude or experience with the female condom, centered around a similar set of factors: aesthetics, difficulties with the male condom, male partner reaction, beliefs about efficacy, and lack of training. These findings underscore the need for additional research and comprehensive education efforts aimed at both technical use and communication skills-building in order to realize the potential of the female condom as an alternative barrier method.

Scripture and Ethics: Twentieth-Century Portraits

How should the Bible be used in Christian Ethics? Although this question has been addressed many times, little attention has gone to how the Bible actually has functioned in constructing theological ethics. In this book, Jeffrey Siker describes and analyzes the Bibles various uses in the theology and ethics of eight of the twentieth centurys most important and influential Christian theologians: Reinhold Niebuhr, H. Richard Niebuhr, Bernard Haring, Paul Ramsey, Stanley Hauerwas, Gustavo Gutierrez, James Cone, and Rosemary Radford Ruether. In approaching each author, Siker organizes his study around five related questions: which biblical texts does each author in fact use; in what ways does each use these texts; how does each envision the authority of the Bible; what kind of hermeneutic does the author employ; finally, what has each authors particular approach to the Bible yielded in terms of Christian ethics, or, in other words, what are some of the practical results? Siker ends each chapter with a critical evaluation of the various problems and prospects for the authors use of Scripture, and concludes the study with a comparison and contrast of the authors respective appropriations of the Sermon on the Mount.