Triple jeopardy for HIV: substance using Severely Mentally Ill Adults

Severely Mentally Ill (SMI) adults have disproportionately high HIV seroprevalence rates. Abuse of alcohol and other substances (AOD) and lifetime exposure to trauma by others are particularly potent risk factors, which, in combination with psychiatric disabilities, create triple jeopardy for HIV infection. This study examined the predictive utility of demographic characteristics; history of physical, emotional, or sexual abuse; extent of drug and alcohol abuse; knowledge about HIV/AIDS; sexual self-efficacy; and condom attitudes toward explaining the variance in a composite of HIV high-risk behavior among 188 SMI women and 158 SMI men. History of sexual abuse, engaging in sexual activities while high on substances, and lower cannabis use were the most significant predictors of HIV sexual risk behaviors. Given the triple jeopardy for HIV risk in this population, a triple barreled approach that simultaneously addresses multiple health risks within an integrated treatment setting is warranted.     

西方艾滋病性风险行为研究的社会性别视野

社会性别作为一个重要的分析范畴,对理解艾滋病在全球范围内的传播有着重要作用。本文从个体、人际关系和文化层次,总结上世纪90年代以来西方学者在艾滋病性风险行为研究中引入的社会性别因素,及其在不同文化背景下的应用情况,并展望了未来艾滋病性风险行为在社会性别途径的研究方向。     

Sexual attitudes and behaviors among adolescents

The purpose of this article is to examine the self-reported sexual attitudes and behaviors of adolescents living in the Midwest. A survey was administered to 463 African American youths ages 11-19. The results indicate that intent to have sexual intercourse, reported likelihood toward having sexual intercourse, and whether participants felt that they would have sex in the next 3 months were predictors of whether they had sexual intercourse at the 3-month follow-up. The results also revealed that the opinions of referent others did not predict sexual intercourse at 3 months. Negative attitudes toward condoms did predict condom use at 3 months and the opinions of referent others also predicted condom use at 3 months. Limitations as well as future research are also discussed.     

Sexual Attitudes and Behaviors Among Adolescents

The purpose of this article is to examine the self-reported sexual attitudes and behaviors of adolescents living in the Midwest. A survey was administered to 463 African American youths ages 11–19. The results indicate that intent to have sexual intercourse, reported likelihood toward having sexual intercourse, and whether participants felt that they would have sex in the next 3 months were predictors of whether they had sexual intercourse at the 3-month follow-up. The results also revealed that the opinions of referent others did not predict sexual intercourse at 3 months. Negative attitudes toward condoms did predict condom use at 3 months and the opinions of referent others also predicted condom use at 3 months. Limitations as well as future research are also discussed.     

Unsafe sex: do feelings matter?

The purpose of this study was to investigate the relationships among self-efficacy for condom use during distress (SE-Condom Distress), self-efficacy related to general HIV prevention skills (SE-HIV), and HIV risk behaviors, attitudes, and knowledge. Two hundred and twenty two adolescents with psychiatric disorders between 13 and 18 years-old participated. Participants completed measures related to HIV Self-Efficacy, HIV Attitudes, and Sexual Behaviors. Self-efficacy for condom use during distress (SE-Condom Distress) was significantly associated with more HIV protective behaviors. Controlling for observed covariates, SE-Condom Distress was the only variable significantly associated with consistent condom use in a multiple logistic regression (OR=2.43). Self-efficacy regarding condom use during affective arousal is closely associated with HIV-related attitudes and behaviors. Clinicians need to be alert to subtle signs of distress as adolescents contemplate safer sexual behavior.     

在艾滋项目中融入社会性别视角

艾滋病的生物医学特征、流行病学特征以及艾滋病问题的社会医学特征决定了艾滋问题不仅是一个医学或健康问题,同时也是一个重大的公共性和社会性的问题。基于艾滋应对与两性角色、地位、权力的交互作用,以全新的视角探索艾滋应对项目的有效途径,可将艾滋应对项目划分为有害项目、无害项目、具有社会性别敏感性项目以及具有创新性的艾滋项目,进而有意识的在艾滋项目中融入社会性别视角。     

Differences in HIV-related knowledge, attitudes, and behavior among psychiatric outpatients with and without a history of a sexually transmitted infection

HIV infection among the mentally ill is estimated to be at least eight times the prevalence in the general population. Psychiatric patients may also be disproportionately vulnerable to other sexually transmitted infections (STIs), but this has not been well studied. We sought to characterize the prevalence and correlates of STIs in a sample of psychiatric outpatients (N=464). Over one-third of the sample (38%) reported a lifetime history of one or more STIs. Multivariate analyses showed that, relative to those without an STI history, patients with a lifetime STI history were more knowledgeable about HIV, expressed stronger intentions to use condoms, and perceived themselves to be at greater risk for HIV. However, those with a past STI were also more likely to report sex with multiple partners and reported more frequent unprotected sex in the past 3 months. Treatment for an STI may increase HIV knowledge and risk reduction motivation, but does not necessarily lead to changes in sexual risk behavior among psychiatric patients. Findings highlight the need for STI/ HIV risk reduction interventions in psychiatric settings, particularly for patients with high-risk profiles.     

我国的吸毒者中艾滋病流行现状与预防措施

目前在我国,吸毒者是艾滋 病感染的高危人群,静脉注射吸毒是 艾滋病的主要传播途径。绝大多数吸 毒者有艾滋病感染／传播的高危行为, 如共用注射器、商业性行为,并且性行 为中有半数从不戴安全套。因此,了解 吸毒者中艾滋病流行现状,提出可行 的预防控制措施十分必要。     

Schizophrenia,AIDS and the Decision to Prescribe HAART

SUMMARY

Individuals with schizophrenia are at risk of developing HIV and are known to experience barriers to optimal medical care. Our goal was to determine, among a cohort of HIV clinicians, whether or not the diagnosis of schizophrenia affected the clinical decision to offer highly active antiretroviral therapy (HAART) to AIDS patients.

This is a cross-sectional study of a random, national sample of HIV experts drawn from the membership of the American Academy of HIV Medicine. Participants were mailed a self-administered questionnaire with a case vignette of a new onset AIDS patient and were specifically asked whether or not they would recommend HAART treatment. Vignettes were randomly assigned to include a diagnosis of schizophrenia or not. We located 649 clinicians (93%); 347 responded (53.4%). Responders and non-responders did not differ in demographics or work characteristics. Recommendation of antiretroviral treatment did not differ between those who received a case vignette with schizophrenia versus those who did not (95.8% vs. 96.6%, p = 0.69). Compared to those who received a case vignette without schizophrenia, those who received vignettes with schizophrenia were more likely to avoid prescribing efavirenz, a medication with known neuropsychiatric side effects (17.7% vs. 45.5%, p < 0.01), more likely to agree to be helped by a specialist (34.5% vs. 12.9%, p < 0.01), and more likely to recommend directly observed therapy (20% vs.10%, p = 0.01). HIV clinicians recognize the importance of recommending HAART treatment to individuals with schizophrenia and AIDS and avoid using antiretroviral medication with known neuropsychiatric side effects.     

论艾滋病预防和控制中的性别歧视——以异性性交往传播的防控为例

艾滋病蔓延已成为中国大陆的一大社会问题。为此,政府采取了一系列的措施,努力进行预防和控制,并取得了显著的成效。但从社会性别视角看,艾滋病的预防和控制中也存在着种种性别歧视,尤其在异性性交往传播的防控方面更为突出。因此,应从性别公正和性别平等出发改善有关艾滋病预防和控制的法律、政策和国家行动,进一步提高艾滋病预防和控制工作的成效。     

The Improvement of China's AIDS Notification System from the Perspective of Human Rights

China has established a two-level normative structure AIDS notification system with the AIDS Prevention and control Regulations as the core and local regulations as the supplement The problem is that the local legislations have different provisions with regard to the subject of notification and whether to adopt mandatory notification, which confronts the implementation of the AIDS notification system and the prevention of AIDS transmission with real difficulties The different attitudes of local legislations to the mandatory notification system for AIDS essentially reflects the dilemma of legislators in balancing the right to privacy of HIV-infected patients and the right to health of their sexual partners from the perspective of rights limitations, this paper aims to conducts interest balance analysis in the aspects of social urgency, public interest, substantive damage and the right to know of others and holds the view that when these two rights conflict with each other, priority should be given to the right to health of HIV-infected patients and their sexual partner as well as public health In terms of specific systems, the AIDS Prevention and control Regulations should establish a mandatory notification system and local legislation should take into consideration of local conditions to make specific provisions on issues of notification subject, notification procedures and confidentiality obligations after notification.     

The Influence of Sexual Orientation on Health Behaviors in Women

SUMMARY

Lesbians may be at risk for poorer health outcomes than heterosexual women because of differential health behaviors and risk factors for disease. Difficulty recruiting representative lesbian populations and a lack of simple, accurate measures of sexual orientation have hindered research about the differential health risks and outcomes faced by lesbian and heterosexual women. The purpose of this article was to (1) examine the relationship between self-chosen sexual orientation labels and other sexual orientation measures and (2) compare the health related behaviors of women of diverse sexual orientations based on simple sexual orientation measures. The participants in this study were women aged 18 to 74 recruited via public announcements in mainstream and minority communities to participate in a randomized trial of breast cancer risk counseling strategies. Sexual orientation, relevant health behaviors and other outcomes related to breast cancer risk and screening were measured. No single measure of sexual behavior or desire appears to accurately measure lesbian sexual orientation. Lesbians were found to participate in mammography and Pap testing at significantly lower levels than bisexuals and heterosexuals. These data add to the growing body of knowledge on lesbian health and point to areas of community action and future research.     

Responding to Gendered Violence Among College Students: The Impact of Participant Characteristics on Direct Bystander Intervention Behavior

ABSTRACT

Bystander intervention has been an effective strategy for crime prevention and has been successful in the context of campus sexual assault. Less is known about the extent to which individual-level factors correlate with intervention behavior in situations of intimate partner violence (IPV) and sexual harassment. The present study used a sample of 377 undergraduate student surveys on a campus without a bystander intervention program to examine the impact of individual-level participant factors on direct intervention across sexual assault, IPV, and sexual harassment scenarios. Findings demonstrated statistically significant differences where positive bystander attitudes and violence prevention efficacy correlated with direct intervention for sexual assault; positive bystander attitudes, personality extroversion, and exposure to a victim increased intervention behavior in an IPV scenario, and positive bystander attitudes and violence prevention efficacy increased direct intervention and lifetime experience of IPV decreased direct intervention in a sexual harassment scenario. Research and policy implications are discussed.     

妇女与艾滋病防治

本文从流行现状与特征、干预策略与措施、防治对策及手段等,多角度分析在妇女中开展艾滋病防治健康教育与行为干预工作的必要性、重要性与紧迫性。建议全社会更多地关注女性在艾滋病预防控制工作中的重要地位及所发挥的作用,共同抗击艾滋病对人类健康和社会进步所构成的威胁,倡导共享人类健康文明,实现构建和谐社会的目标。     

Violence and Sexual Minority Youth

Abstract

Among the most maligned and harassed students in high schools are those who are perceived not to fit the norms for sexual behavior. These include gay and lesbian students, bisexual students, transgendered students, effeminate heterosexual males, and masculine-acting heterosexual females. Together these students are the targets of a wide range of negative behaviors from subtle exclusion to physical assault. In addition, many develop negative attitudes towards themselves which put them at increased risk for self-harm and suicide. The origin of these attitudes and behaviors is societal homophobia that fuels social aggression against this stigmatized group. Although challenging, educators can assist in undermining the effects of homophobia on sexual minorities through teaching tolerance, sponsoring support groups that address these issues, and providing educational opportunities about sexual minority youth.     

Preventing Dating Violence in Public Schools

Abstract

Many communities offer programs aimed at improving teen dating skills and knowledge about violence and sexual behavior. This research study evaluates one such program, operated by an interagency collaborative. Each of four participating community agencies provided one hour of curriculum during one week of health class. Lecture, group activities, and films were used in the intervention. A 0 X 0 design was used to examine changes in knowledge and attitudes among 74 students. Results indicate that most students began with fairly high knowledge levels and appropriate attitudes. Nevertheless, the program did appear to have a positive impact on those who exhibited less knowledge about and more tolerant attitudes toward exploitive dating behaviors at pre-test. Implications of results for the school context are discussed.     

关注艾滋病对老年妇女的影响

老年妇女同样面临感染艾滋病风险,她们的感染人数在悄然增长。子女感染艾滋病病毒后,对老年妇女的经济、健康、心理和晚年保障各方面产生严重后果。在广大发展中国家,她们还担负着照料和支持艾滋病子女的重要角色。在以往艾滋病的研究和行动中,公众、研究者和决策者都忽略了艾滋病对处于年龄和性别双重弱势地位的老年妇女的影响,妇女在艾滋病相关工作中很少得到关注和重视。因此,有必要了解艾滋病对老年妇女的影响并研究应采取的对策。     

Individual differences in safe behavior: A safety practitioner's viewpoint

SUMMARY

This paper focuses on the school as a setting for community-based prevention of factors that place learners at risk such as poverty, violence, substance abuse, learning difficulties and HIV/AIDS. It examines the development of school-based structures aimed at addressing these issues. The health promoting and inclusive schools approaches are explored as strategies to address these and other barriers to learning.

Reference is made to innovative practice at a school in a disadvantaged community outside of Cape Town. The case study reveals how school-based teams could be utilized to mobilize school communities in generating solutions to the difficulties that they encounter.     

检察机关对网络舆情的把握与应用

网络舆情是指网民通过互联网对自己关心或与自身利益紧密相关的社会中各种现象、问题所表达的信念、态度、意见和情绪等表现的总和,它直接反映了社会公众对执政者不断改善民情状况的一种诉求和意愿。其具有主观性与多元化、突发性与经常化、偏差性与无序化等特点。检察机关应该主动适应网络信息发展的迅猛态势和网络时代信息传播的特点,从建立机制入手,全面、准确、深刻把握网络舆情,主动引导网络舆论、应用网络舆情,服务于检察工作的科学发展。     

Teachers' Attitudes and Beliefs About Bullying

Abstract

Two exploratory studies were conducted to investigate U.S. teachers' attitudes and beliefs about bullying. Although most teachers believed they were doing a good job at preventing bullying, results indicate that some teachers hold beliefs that are at odds with current best practices in bullying prevention and intervention. First-year teachers would like more training in bullying despite reported confidence in their abilities to handle bullying, and report they did not receive such training either in teacher preparation programs or in-service training.