Sonja Feist-Price

Effects of Peer Education on the Peer Educators in a School-Based HIV Prevention Program: Where Should Peer Education Research Go from Here?

Although many HIV/AIDS prevention programs for adolescents have used peer educators to deliver risk reduction information, fewresearchers have evaluated the effects of participation in educational activities on the peer educators themselves. The present study compares several outcomes experienced by peer educators involved in a school-based HIV prevention program with those of their classmates to determine areas in which involvement in the curriculum had an effect on peer educators. Analyses revealed few differences between peer educators that could be attributed to the implementation of the intervention. The findings are discussed in terms of their implications for prevention programs targeting adolescent populations, and suggestions are made concerning the importance of future research on the selection, training, and integration of peer educators into school-based programs.

Longitudinal Test of a Multiple Domain Model of Adolescent Condom Use

A comprehensive multiple domain model (MDM) to understand condom use in adolescents was proposed and tested using structural equation modeling of data at three time points. The proposed model integrates social psychological theory, demographic and personality factors, social environment, and situational/contextual variables. Adolescents who were sexually active at time 2 (6 months after baseline) and time 3 (1 year after time 2) and completed surveys at all three time points were included in the analyses (N = 511). An iterative process of model testing resulted in a structural equation model that provided a good fit to the data (CFI = .92, RMSEA = .04). Models comparing gender and race as moderators also were calculated and supported the generalizability of the model. Results provide support for an MDM that goes beyond traditional social psychological models for a broader understanding of condom use in adolescents. Implications for further theory testing and safer sexual interventions are discussed.

Childhood sexual abuse in black men who have sex with men: results from three qualitative studies.

This report describes the high prevalence and context of childhood sexual abuse (CSA) among Black men who have sex with men (MSM) across 3 independent qualitative studies. Semistructured one-on-one interviews were conducted with 87 Black MSM across 3 cities (Rochester, NY, n = 28; Lexington, KY /Atlanta, GA, n = 30; and Atlanta, GA, n = 29). A combined CSA prevalence of 32% (28/87) was found among the 3 samples, despite variation in geographic location, mean age, and sexual identification. Common themes emerging across the 3 samples included prolonged and repeated abuse by a close male relative; blaming of same-sex desire on CSA; and descriptions of adverse mental health reactions to CSA. Implications of CSA and its potential influence on the mental health and risky sexual behavior among Black MSM are discussed.

VR Services for Persons with Severe/Profound Mental Retardation Does Race Matter?

This article examines the relationship between race, vocational rehabilitation (VR) services, and the rehabilitation outcomes (i.e., closure status and income) of persons with severe/profound mental retardation. Six predictor variables (race, business and vocational training, on-the-job training, transportation, adjustment, and job placement) were used to predict one dichotomous criterion variable—closure status—and one continuous criterion variable—income (i.e., level of weekly earnings). Logistic regression analysis revealed that European Americans were significantly more likely to achieve closure success when compared to African Americans. Findings also indicated that persons with severe/profound mental retardation who were provided with job placement services were significantly more likely to achieve closure success (Status 26). Results are presented for each criterion variable, and the implications of the findings for service and research are discussed.

Using computer technology for HIV prevention among African-Americans: development of a tailored information program for safer sex (TIPSS)

New prevention options are urgently needed for African-Americans in the United States given the disproportionate impact of HIV/AIDS on this group. This combined with recent evidence supporting the efficacy of computer technology-based interventions in HIV prevention led our research group to pursue the development of a computer-delivered individually tailored intervention for heterosexually active African-Americans--the tailored information program for safer sex (TIPSS). In the current article, we discuss the development of the TIPSS program, including (i) the targeted population and behavior, (ii) theoretical basis for the intervention, (iii) design of the intervention, (iv) formative research, (v) technical development and testing and (vi) intervention delivery and ongoing randomized controlled trial. Given the many advantages of computer-based interventions, including low-cost delivery once developed, they offer much promise for the future of HIV prevention among African-Americans and other at-risk groups.

Combining and adapting American school-based alcohol and HIV prevention programmes in South Africa: The HAPS project

Abstract Adolescents in South Africa are at particularly high risk for human immunodeficiency virus (HIV), as well as other sexually transmitted infections. Because rates are so high, using minimal time and resources to develop effective interventions is essential. One strategy to achieve this goal is to modify and adapt western school-based preventive interventions for application in South African schools. This study focuses on the adaptation and integration of two interventions with proven effectiveness in the United States in order to ensure cultural relevance in South Africa and its subsequent testing in eight high schools located in townships near Pietermaritzburg, KwaZulu-Natal province. The findings reported in this paper reflect data from the first cohort of students, which included 1095 9th grade learners. Participants were assessed both 4–6 months and 15–18 months following baseline data collection. Results indicated significant differences in change between students in the intervention and comparison conditions on sexual refusal self-efficacy, intentions to have sex, attitudes about sex, initiation of sex, intention to use alcohol with sex, alcohol refusal self-efficacy and attitudes about alcohol. These results suggest that, after careful adaptation for cultural differences, behavioural interventions developed in western countries may achieve effectiveness in other contexts including township schools in South Africa.

Targeting HIV prevention on African American crack and injection drug users.

The use of drugs in the African American community, particularly crack cocaine, has been linked to sexual risk-taking behavior, which increases the likelihood that persons will become infected with Human Immuno Virus. In order to more fully understand risk-taking behavior and to target interventions among African American men and women, this study used data collected from 1277 individuals residing in Lexington and Louisville, Kentucky, who were recruited into National Institute on Drug Abuse (NIDA) Cooperative Agreement Project from 1993 to 1998. The study compared African Americans treated for Sexually transmitted diseases (STDs) (n = 292) with African Americans who reported never being treated for a STD (n = 504) with regard to HIV information, awareness, and the number of HIV tests between those with and without STD exposure. Additionally, we examine gender differences among African Americans who have and have not been exposed to STDs on risk behaviors and HIV knowledge, awareness, and testing. It was hypothesized that African American drug users in the STD group would engage in more risk behaviors than those who reported no STDs. Results indicated that individuals in both groups, the STD exposure group and the no STD group, engaged in similar HIV-risky behaviors. However, the STD group used a greater number of different drugs in their lifetime. The STD group reported they were more likely to get HIV and were more frequently tested for HIV. Females with an STD history were more likely to have been in drug user treatment and to perceive themselves as homeless. Both males and females in the STD group were more likely to report involvement in exchanging sex.

African American Women Living with HIV/AIDS: Mental Health Issues

Abstract The number of African American women infected with the human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS) is alarming. As with any other reaction to catastrophe or life threatening diseases, from the time African American women first learn of their HIV-positive serostatus they navigate various levels of acceptance and a multitude of mental health issues. This manuscript explores these issues related to African American women with HIV/AIDS. Careful consideration is given to the stages of adjustment and related mental health challenges that women might experience. Also explored are the reciprocal impact of children, other family members and significant others on the mental health status of African American women living with HIV/AIDS. Implications for clinical practice are also identified.