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| Publications of Kathleen J. Sikkema :chronological alphabetical combined listing:%% Journal Articles @article{fds349548, Author = {Joska, JA and Andersen, L and Rabie, S and Marais, A and Ndwandwa, E-S and Wilson, P and King, A and Sikkema, KJ}, Title = {COVID-19: Increased Risk to the Mental Health and Safety of Women Living with HIV in South Africa.}, Journal = {Aids and Behavior}, Year = {2020}, Month = {April}, url = {http://dx.doi.org/10.1007/s10461-020-02897-z}, Doi = {10.1007/s10461-020-02897-z}, Key = {fds349548} } @article{fds348727, Author = {Kohrt, BA and Turner, EL and Rai, S and Bhardwaj, A and Sikkema, KJ and Adelekun, A and Dhakal, M and Luitel, NP and Lund, C and Patel, V and Jordans, MJD}, Title = {Reducing mental illness stigma in healthcare settings: Proof of concept for a social contact intervention to address what matters most for primary care providers.}, Journal = {Social Science and Medicine}, Volume = {250}, Pages = {112852}, Year = {2020}, Month = {February}, url = {http://dx.doi.org/10.1016/j.socscimed.2020.112852}, Abstract = {Initiatives for integration of mental health services into primary care are underway through the World Health Organization's mental health Gap Action Programme (mhGAP) and related endeavors. However, primary healthcare providers' stigma against persons with mental illness is a barrier to success of these programs. Therefore, interventions are needed to reduce stigma among primary healthcare providers. We developed REducing Stigma among HealthcAre ProvidErs (RESHAPE), a theoretically-grounded intervention that draws upon the medical anthropology conceptual framework of "what matters most." RESHAPE addresses three domains of threats to what matters most: survival, social, and professional. In a proof-of-concept study, mental health service users and aspirational healthcare providers (primary healthcare providers actively incorporating mental health services) were trained to co-facilitate the RESHAPE intervention embedded within mhGAP training in Nepal. Two trainings with the RESHAPE anti-stigma component were held with 41 primary healthcare providers in Nepal. Evaluation of the training included four focus groups and 25 key informant interviews. Stigmatizing attitudes and role play-based clinical competency, assessed with the ENhancing Assessment of Common Therapeutic factors tool (ENACT), were evaluated pre-training and followed-up at four and 16 months. The study was conducted from February 2016 through June 2017. In qualitative interviews, primary healthcare providers described changes in perceptions of violence (survival threats) and the ability to treat mental illness effectively (professional threats). Willingness to interact with a person with mental illness increased from 54% pre-training to 81% at 16 months. Observed clinical competency increased from 49% pre-training to 93% at 16-months. This proof-of-concept study supports reducing stigma by addressing what matters most to healthcare providers, predominantly through mitigating survival and professional threats. Additional efforts are needed to address social threats. These findings support further exploration of service user and aspirational figure involvement in mhGAP trainings based on a "what matters most" conceptual framework.}, Doi = {10.1016/j.socscimed.2020.112852}, Key = {fds348727} } @article{fds348069, Author = {Knettel, BA and Robertson, C and Ciya, N and Coleman, JN and Elliott, SA and Joska, JA and Sikkema, KJ}, Title = {"I cannot change what happened to me, but I can learn to change how I feel": A case study from ImpACT, an intervention for women with a history of sexual trauma who are living with HIV in Cape Town, South Africa.}, Journal = {Psychotherapy (Chicago, Ill.)}, Year = {2019}, Month = {December}, url = {http://dx.doi.org/10.1037/pst0000263}, Abstract = {Sexual trauma is highly prevalent among women living with HIV in South Africa, and there is a great need for psychotherapeutic interventions to address these concerns. Improving AIDS Care After Trauma (ImpACT) is a manualized intervention, based on stress and coping theories, that builds skills for coping with sexual trauma and HIV to promote long-term HIV care engagement. Using qualitative case study methodology, we report the case of Xoliswa, a 34-year-old woman with a complex history of sexual trauma and alcohol use who was diagnosed with HIV 1 year prior to enrollment in ImpACT. The interventionist, a lay counselor, worked with Xoliswa in a primary care clinic to address her concerns by exploring personal values, managing barriers to HIV care, and teaching active coping. Xoliswa's drinking reduced, symptoms of trauma and depression improved, and she maintained strong HIV care engagement. The interventionist experienced stress and emotional challenges in delivering ImpACT to Xoliswa and other highly traumatized women, and the interventionist's skill development and support received through training and supervision are briefly discussed. The case demonstrates the feasibility of ImpACT in a resource-limited setting and highlights themes and barriers in therapy, which can inform future interventions for women living with HIV. (PsycINFO Database Record (c) 2019 APA, all rights reserved).}, Doi = {10.1037/pst0000263}, Key = {fds348069} } @article{fds346465, Author = {Olson, B and Vincent, W and Meyer, JP and Kershaw, T and Sikkema, KJ and Heckman, TG and Hansen, NB}, Title = {Depressive symptoms, physical symptoms, and health-related quality of life among older adults with HIV.}, Journal = {Quality of Life Research}, Volume = {28}, Number = {12}, Pages = {3313-3322}, Year = {2019}, Month = {December}, url = {http://dx.doi.org/10.1007/s11136-019-02271-0}, Abstract = {PURPOSE:In the United States, approximately 45% of persons living with HIV (PLHIV) are ≥ 50 years of age. Many older PLHIV have multi-morbidities that complicate HIV infection and/or interfere with, or are exacerbated by, antiretroviral treatment. Physical health symptoms and psychiatric disorders, particularly depression, can worsen life quality in older PLHIV. METHODS:This study assessed associations among physical symptoms, indicators of HIV-related health status (i.e., time since diagnosis; ever diagnosed with AIDS; having attained viral suppression), depressive symptoms, and health-related quality of life (HRQoL) in older PLHIV. Regression analyses examined data from 296 PLHIV ≥ 50 years of age living in Cincinnati, OH, Columbus, OH, and New York City. RESULTS:Depressive symptoms and physical symptoms, particularly those related to appearance and sexual functioning, most strongly predicted HRQoL. Indicators of HIV health status did not significantly predict HRQoL. Depressive symptoms were a particularly robust predictor of HRQoL, even when accounting for physical health symptoms. CONCLUSION:Findings suggest that symptom management is critical to HRQoL in older PLHIV, and symptoms related to physical appearance and sexual functioning should not be overlooked in this growing population.}, Doi = {10.1007/s11136-019-02271-0}, Key = {fds346465} } @article{fds341893, Author = {Knettel, BA and Mulawa, MI and Knippler, ET and Ciya, N and Robertson, C and Joska, JA and Sikkema, KJ}, Title = {Women's perspectives on ImpACT: a coping intervention to address sexual trauma and improve HIV care engagement in Cape Town, South Africa.}, Journal = {Aids Care Psychological and Socio Medical Aspects of Aids/Hiv}, Volume = {31}, Number = {11}, Pages = {1389-1396}, Year = {2019}, Month = {November}, url = {http://dx.doi.org/10.1080/09540121.2019.1587368}, Abstract = {HIV-infected women who have experienced sexual violence face unique challenges in their HIV care engagement and adherence to antiretroviral medications (ARVs). Improving AIDS Care after Trauma (ImpACT) is a brief counseling intervention aimed at reducing the negative impact of sexual trauma and HIV, building coping skills, and improving long-term HIV care engagement. We conducted a randomized controlled pilot trial of ImpACT with 64 women initiating ARVs in Cape Town, South Africa, with results suggesting the intervention can reduce PTSD symptoms and increase motivation to adhere to ARVs. For the current study, we abstracted data from ImpACT worksheets completed by 31 participants during intervention sessions, and qualitative responses from post-intervention surveys, to examine mechanisms, facilitators, and barriers to change in the intervention. Data included participant descriptions of the values informing their care, barriers to participation, and perceived benefits of the intervention related to coping with trauma and improving care engagement. During the first session, women reported feelings of shame, sadness, and anger that led to social isolation, mistrust, and damaged relationships. Barriers to participation included work and school demands, issues with transportation, finances, and discomfort in talking about HIV and trauma, particularly in group sessions. Despite these challenges, several women stated they developed more positive thinking, felt more confident, and improved their interpersonal relationships. Participants also reported substantial positive impact on symptoms of sexual trauma and motivation to continue with long-term HIV care, and clearer understanding of barriers and facilitators to ARV adherence. ImpACT is a promising intervention model for building adaptive coping skills and adherence to HIV treatment, informed by personal values, among women with a history of trauma in this high-risk setting. The data also offer insights into strategies to strengthen the intervention, overcome barriers to participation, encourage the practical application of skills, and promote long-term HIV care engagement.}, Doi = {10.1080/09540121.2019.1587368}, Key = {fds341893} } @article{fds333641, Author = {Choi, KW and Houts, R and Arseneault, L and Pariante, C and Sikkema, KJ and Moffitt, TE}, Title = {Maternal depression in the intergenerational transmission of childhood maltreatment and its sequelae: Testing postpartum effects in a longitudinal birth cohort.}, Journal = {Development and Psychopathology}, Volume = {31}, Number = {1}, Pages = {143-156}, Year = {2019}, Month = {February}, url = {http://dx.doi.org/10.1017/s0954579418000032}, Abstract = {Mothers who have experienced childhood maltreatment are more likely to have children also exposed to maltreatment, a phenomenon known as intergenerational transmission. Factors in the perinatal period may contribute uniquely to this transmission, but timing effects have not been ascertained. Using structural equation modeling with 1,016 mothers and their 2,032 children in the Environmental Risk Longitudinal Twin Study, we tested the mediating role of postpartum depression between maternal childhood maltreatment and a cascade of negative child outcomes, specifically child exposure to maltreatment, internalizing symptoms, and externalizing symptoms: (a) adjusting for later maternal depression, (b) comparing across sex differences, and (c) examining the relative role of maltreatment subtypes. Mothers who had been maltreated as children, especially those who had experienced emotional or sexual abuse, were at increased risk for postpartum depression. In turn, postpartum depression predicted children's exposure to maltreatment, followed by emotional and behavioral problems. Indirect effects from maternal childhood maltreatment to child outcomes were robust across child sex and supported significant mediation through postpartum depression; however, this appeared to be carried by mothers' depression beyond the postpartum period. Identifying and treating postpartum depression, and preventing its recurrence, may help interrupt the intergenerational transmission of maltreatment and its sequelae.}, Doi = {10.1017/s0954579418000032}, Key = {fds333641} } @article{fds349123, Author = {Sikkema, KJ and Coleman, JN}, Title = {Psychotherapy for PTSD and stress disorders}, Pages = {193-222}, Booktitle = {Global Mental Health and Psychotherapy: Adapting Psychotherapy for Low- and Middle-Income Countries}, Year = {2019}, Month = {January}, ISBN = {9780128149331}, url = {http://dx.doi.org/10.1016/B978-0-12-814932-4.00009-4}, Abstract = {© 2019 Elsevier Inc. All rights reserved. LMIC are affected by serious issues that contribute to the development of traumatic stress, such as war and conflict, internal displacement, poverty, food insecurity, and disease. Evidence-based psychological treatments for PTSD have been developed and tested in high-income countries, but less research has been conducted in LMIC to examine if similar treatments for PTSD are efficacious in various cultural contexts and within a range of delivery settings. In this chapter, we review psychological interventions for PTSD and stress disorders that have been evaluated in LMIC, provide an overview of their efficacy, synthesize the strengths and weaknesses of empirical work to date, and discuss future directions for research and treatment implementation. Resulting studies were organized by population stressor into the following sections: (American Psychiatric Association, 2013) conflict and violence, (Scott, Koenen, Aguilar-Gaxiola, et al., 2013) natural disasters, and (Turner & Lloyd, 1995) gender-based violence, including comorbid medical conditions. Existing interventions have several methodological strengths, such as numerous studies utilizing empirically supported approaches, group-based intervention structures, and delivery by nonspecialists in mental health (e.g., lay counselors or community health workers). The treatments evaluated are on a continuum of traditions from those in the CBT framework such as TF-CBT and NET to broader psychological treatments such as problem-solving, IPT, and BA. A limitation is that trials have largely compared treatments with a wait list control, no-treatment control, or treatment-as-usual condition. Therefore, for many PTSD trials, the extent of the effect attributable to treatment is not clear. Future directions should include testing mechanisms of change in treatment, developing brief and scalable interventions that have been culturally tailored, and using attention-matched control comparisons to elucidate effective treatment components.}, Doi = {10.1016/B978-0-12-814932-4.00009-4}, Key = {fds349123} } @article{fds338004, Author = {Watt, MH and Knippler, ET and Knettel, BA and Sikkema, KJ and Ciya, N and Myer, L and Joska, JA}, Title = {HIV Disclosure Among Pregnant Women Initiating ART in Cape Town, South Africa: Qualitative Perspectives During the Pregnancy and Postpartum Periods.}, Journal = {Aids and Behavior}, Volume = {22}, Number = {12}, Pages = {3945-3956}, Year = {2018}, Month = {December}, url = {http://dx.doi.org/10.1007/s10461-018-2272-5}, Abstract = {For women enrolled in prevention of mother-to-child transmission (PMTCT) programs, non-disclosure of their HIV status can be a significant barrier to sustained HIV care engagement. To explore decision-making surrounding HIV disclosure among HIV-infected pregnant women, we conducted repeated in-depth interviews during pregnancy and postpartum with 20 women recruited from a PMTCT clinic in Cape Town, South Africa. Three domains were examined using thematic analysis: (1) disclosure experiences, (2) challenges associated with partner disclosure, and (3) implications of nondisclosure. All women had disclosed to someone by the time of the baby's birth, typically limiting their disclosure to trusted individuals. Only half of participants disclosed to the father of the child. Nondisclosure, particularly to partners, was a significant source of worry and stress. Women used pregnancy as an explanation for using medication and attending frequent clinic appointments, and recognized impending challenges in the postpartum period when this excuse would no longer apply. Results suggest that PMTCT programs have a key role to play in helping individuals to make decisions about HIV disclosure, and assisting patients to navigate the disclosure process, especially with partners.}, Doi = {10.1007/s10461-018-2272-5}, Key = {fds338004} } @article{fds338003, Author = {Fletcher, OV and May, PA and Seedat, S and Sikkema, KJ and Watt, MH}, Title = {Attitudes toward alcohol use during pregnancy among women recruited from alcohol-serving venues in Cape Town, South Africa: A mixed-methods study.}, Journal = {Social Science & Medicine}, Volume = {215}, Pages = {98-106}, Year = {2018}, Month = {October}, url = {http://dx.doi.org/10.1016/j.socscimed.2018.09.008}, Abstract = {BACKGROUND:The Western Cape Province of South Africa has one of the highest rates of fetal alcohol spectrum disorder (FASD) globally. Effective prevention of FASD requires understanding women's attitudes about alcohol use during pregnancy and whether these attitudes translate into behavior. OBJECTIVE:The goal of this mixed-methods study was to describe attitudes toward alcohol use during pregnancy and examine how these attitudes influence drinking behaviors during pregnancy. METHOD:Over a five month period, 200 women were recruited from alcohol-serving venues in a township in Cape Town; a sub-set of 23 also completed in-depth interviews. Potential gaps between attitudes and behavior were described, and logistic regression models examined predictors of harmful attitudes toward alcohol use during pregnancy. Interviews were reviewed and coded for emergent themes. RESULTS:Most women (n = 176) reported at least one pregnancy. Among these, the majority (83%) had positive preventive attitudes, but more than half of these still reported alcohol use during a previous pregnancy. The strongest predictors of harmful attitudes were a history of physical or sexual abuse and drinking during a previous pregnancy. Qualitative analysis revealed several themes that contributed to alcohol use during pregnancy: 1) having an unplanned pregnancy; 2) drinking because of stress or to cope with abuse/trauma; 3) reliance on the venue for support; 4) socialization; and 5) feelings of invincibility. CONCLUSIONS:The findings highlight an attitude-behavior gap and suggest that positive preventive attitudes are insufficient to elicit FASD preventive behavior. Interventions are needed that go beyond education to build intrinsic motivation and structural support to refrain from alcohol use during pregnancy.}, Doi = {10.1016/j.socscimed.2018.09.008}, Key = {fds338003} } @article{fds332047, Author = {Cherenack, EM and Sikkema, KJ and Watt, MH and Hansen, NB and Wilson, PA}, Title = {Avoidant Coping Mediates the Relationship Between Self-Efficacy for HIV Disclosure and Depression Symptoms Among Men Who Have Sex with Men Newly Diagnosed with HIV.}, Journal = {Aids and Behavior}, Volume = {22}, Number = {10}, Pages = {3130-3140}, Year = {2018}, Month = {October}, url = {http://dx.doi.org/10.1007/s10461-018-2036-2}, Abstract = {HIV diagnosis presents a critical opportunity to reduce secondary transmission, improve engagement in care, and enhance overall well-being. To develop relevant interventions, research is needed on the psychosocial experiences of newly diagnosed individuals. This study examined avoidant coping, self-efficacy for HIV disclosure decisions, and depression among 92 newly diagnosed men who have sex with men who reported recent sexual risk behavior. It was hypothesized that avoidant coping would mediate the relationship between self-efficacy and depression. Cross-sectional surveys were collected from participants 3 months after HIV diagnosis. To test for mediation, multiple linear regressions were conducted while controlling for HIV disclosure to sexual partners. Self-efficacy for HIV disclosure decisions showed a negative linear relationship to depression symptoms, and 99% of this relationship was mediated by avoidant coping. The index of mediation of self-efficacy on depression indicated a small-to-medium effect. Higher self-efficacy was related to less avoidant coping, and less avoidant coping was related to decreased depression symptoms, all else held constant. These findings highlight the role of avoidant coping in explaining the relationship between self-efficacy for HIV disclosure decisions and depression.}, Doi = {10.1007/s10461-018-2036-2}, Key = {fds332047} } @article{fds333505, Author = {Weisburd, D and Cave, B and Nelson, M and White, C and Haviland, A and Ready, J and Lawton, B and Sikkema, K}, Title = {Mean Streets and Mental Health: Depression and Post-Traumatic Stress Disorder at Crime Hot Spots.}, Journal = {American Journal of Community Psychology}, Volume = {61}, Number = {3-4}, Pages = {285-295}, Year = {2018}, Month = {June}, url = {http://dx.doi.org/10.1002/ajcp.12232}, Abstract = {This study explores the relationship between mental health and place at microgeographic units of analysis. We examine self-reported symptomology for depression and PTSD for 2,724 survey respondents interviewed in three types of randomly selected street segments: violent crime hot spots, cool spots, and cold spots. We find that the mean symptomology score is 61% higher for depression in violent crime hot spots than cold spots, and 85% higher for PTSD. Overall, we estimate that 14.8% of residents of violent crime hot spots meet thresholds for moderate depression or a diagnosis of PTSD. This can be compared to only 6.5% of residents at the cold spots. Using PSM and weighted negative binomial regression approaches we show that observable selection factors are not responsible for the relationships identified. Examining geographic influences, we find an important area effect of violent crime for both mental health measures, and an additional impact of the specific street of residence for PTSD.}, Doi = {10.1002/ajcp.12232}, Key = {fds333505} } @article{fds336553, Author = {Rai, S and Gurung, D and Kaiser, BN and Sikkema, KJ and Dhakal, M and Bhardwaj, A and Tergesen, C and Kohrt, BA}, Title = {A service user co-facilitated intervention to reduce mental illness stigma among primary healthcare workers: Utilizing perspectives of family members and caregivers.}, Journal = {Fam Syst Health}, Volume = {36}, Number = {2}, Pages = {198-209}, Year = {2018}, Month = {June}, url = {http://dx.doi.org/10.1037/fsh0000338}, Abstract = {INTRODUCTION: Service users' involvement as cofacilitators of mental health trainings is a nascent endeavor in low- and middle-income countries, and the role of families on service user participation in trainings has received limited attention. This study examined how caregivers perceive and facilitate service user's involvement in an antistigma program that was added to mental health Gap Action Program (mhGAP) trainings for primary care workers in Nepal. METHOD: Service users were trained as cofacilitators for antistigma and mhGAP trainings delivered to primary care workers through the REducing Stigma among HealthcAre ProvidErs (RESHAPE) program. Key informant interviews (n = 17) were conducted with caregivers and service users in RESHAPE. RESULTS: Five themes emerged: (a) Caregivers' perceived benefits of service user involvement included reduced caregiver burden, learning new skills, and opportunities to develop support groups. (b) Caregivers' fear of worsening stigma impeded RESHAPE participation. (c) Lack of trust between caregivers and service users jeopardized participation, but it could be mitigated through family engagement with health workers. (d) Orientation provided to caregivers regarding RESHAPE needed greater attention, and when information was provided, it contributed to stigma reduction in families. (e) Time management impacted caregivers' ability to facilitate service user participation. DISCUSSION: Engagement with families allows for greater identification of motivational factors and barriers impacting optimal program performance. Caregiver involvement in all program elements should be considered best practice for service user-facilitated antistigma initiatives, and service users reluctant to include caregivers should be provided with health staff support to address barriers to including family. (PsycINFO Database Record}, Doi = {10.1037/fsh0000338}, Key = {fds336553} } @article{fds333642, Author = {Sikkema, KJ and Choi, KW and Robertson, C and Knettel, BA and Ciya, N and Knippler, ET and Watt, MH and Joska, JA}, Title = {Development of a coping intervention to improve traumatic stress and HIV care engagement among South African women with sexual trauma histories.}, Journal = {Evaluation and Program Planning}, Volume = {68}, Pages = {148-156}, Year = {2018}, Month = {June}, url = {http://dx.doi.org/10.1016/j.evalprogplan.2018.02.007}, Abstract = {This paper describes the development and preliminary trial run of ImpACT (Improving AIDS Care after Trauma), a brief coping intervention to address traumatic stress and HIV care engagement among South African women with sexual trauma histories. We engaged in an iterative process to culturally adapt a cognitive-behavioral intervention for delivery within a South African primary care clinic. This process involved three phases: (a) preliminary intervention development, drawing on content from a prior evidence-based intervention; (b) contextual adaptation of the curriculum through formative data collection using a multi-method qualitative approach; and (c) pre-testing of trauma screening procedures and a subsequent trial run of the intervention. Feedback from key informant interviews and patient in-depth interviews guided the refinement of session content and adaptation of key intervention elements, including culturally relevant visuals, metaphors, and interactive exercises. The trial run curriculum consisted of four individual sessions and two group sessions. Strong session attendance during the trial run supported the feasibility of ImpACT. Participants responded positively to the logistics of the intervention delivery and the majority of session content. Trial run feedback helped to further refine intervention content and delivery towards a pilot randomized clinical trial to assess the feasibility and potential efficacy of this intervention.}, Doi = {10.1016/j.evalprogplan.2018.02.007}, Key = {fds333642} } @article{fds328948, Author = {Skalski, LM and Towe, SL and Sikkema, KJ and Meade, CS}, Title = {Memory Impairment in HIV-Infected Individuals with Early and Late Initiation of Regular Marijuana Use.}, Journal = {Aids Behav}, Volume = {22}, Number = {5}, Pages = {1596-1605}, Year = {2018}, Month = {May}, url = {http://dx.doi.org/10.1007/s10461-017-1898-z}, Abstract = {Marijuana use is disproportionately prevalent among HIV-infected individuals. The strongest neurocognitive effect of marijuana use is impairment in the domain of memory. Memory impairment is also high among HIV-infected persons. The present study examined 69 HIV-infected individuals who were stratified by age of regular marijuana initiation to investigate how marijuana use impacts neurocognitive functioning. A comprehensive battery assessed substance use and neurocognitive functioning. Findings indicated early onset marijuana users (regular use prior to age 18), compared to non-marijuana users and late onset marijuana users (regular use at age 18 or later), were over 8 times more likely to have learning impairment and nearly 4 times more likely to have memory impairment. A similar pattern of early onset marijuana users performing worse in learning emerged when examining domain deficit scores. The potential for early onset of regular marijuana use to exacerbate already high levels of memory impairment among HIV-infected persons has important clinical implications, including increased potential for medication non-adherence and difficulty with independent living.}, Doi = {10.1007/s10461-017-1898-z}, Key = {fds328948} } @article{fds331544, Author = {Sikkema, KJ and Mulawa, MI and Robertson, C and Watt, MH and Ciya, N and Stein, DJ and Cherenack, EM and Choi, KW and Kombora, M and Joska, JA}, Title = {Improving AIDS Care After Trauma (ImpACT): Pilot Outcomes of a Coping intervention Among HIV-Infected Women with Sexual Trauma in South Africa.}, Journal = {Aids and Behavior}, Volume = {22}, Number = {3}, Pages = {1039-1052}, Year = {2018}, Month = {March}, url = {http://dx.doi.org/10.1007/s10461-017-2013-1}, Abstract = {Improving AIDS Care after Trauma (ImpACT), a coping intervention for HIV-infected women with sexual abuse histories, was evaluated for feasibility and potential efficacy in a public clinic in Cape Town, South Africa. Sixty-four participants were enrolled prior to starting antiretroviral therapy (ART). After completing baseline assessments, participants were randomly assigned to standard of care (SoC: three adherence counseling sessions) or ImpACT (SoC plus four individual and three group sessions). Participants completed assessments at 3 months (after individual sessions) and 6 months post-baseline. In exploratory analysis of primary outcomes, ImpACT participants, compared to SoC, reported greater reductions in avoidance and arousal symptoms of PTSD and greater increases in ART adherence motivation at 3 months. Clinically significant decreases in overall PTSD symptoms were also demonstrated at 3 months. These effects continued as trends at the 6-month assessment, in addition to increases in social/spiritual coping. In analysis of secondary outcomes, high levels of non-adherence to ART and poor care engagement were evident at 6 months, with no differences between study arms. A trauma-focused, culturally-adapted individual intervention delivered by a non-specialist in the HIV care setting is feasible and acceptable. Preliminary findings suggest ImpACT has potential to reduce PTSD symptoms and increase ART adherence motivation, but a more intensive intervention may be needed to improve and maintain care engagement among this population. TRIAL REGISTRATION:ClinicalTrials.gov NCT02223390.}, Doi = {10.1007/s10461-017-2013-1}, Key = {fds331544} } @article{fds333034, Author = {Mulaudzi, M and Dlamini, BN and Coetzee, J and Sikkema, K and Gray, G and Dietrich, JJ}, Title = {Perceptions of counsellors and youth-serving professionals about sexual and reproductive health services for adolescents in Soweto, South Africa.}, Journal = {Reproductive Health}, Volume = {15}, Number = {1}, Pages = {21}, Year = {2018}, Month = {February}, url = {http://dx.doi.org/10.1186/s12978-018-0455-1}, Abstract = {BACKGROUND:Adolescents in South Africa remain vulnerable to HIV. Therefore, it is crucial to provide accessible adolescent-friendly HIV prevention interventions that are sensitive to their needs. This study aimed to investigate the perceptions of HIV counsellors and other youth-serving professionals about the barriers to providing adolescent youth-friendly sexual and reproductive health services to adolescents in Soweto, South Africa. The study also explored how sexual and reproductive health services in South Africa could be improved to become more accessible to adolescents. METHODS:The research team conducted two focus group discussions with HIV counsellors, and 19 semi-structured interviews with youth-serving professionals from organisations working with adolescents. Audio-recorded data were transcribed verbatim and analysed using thematic analysis. RESULTS:The results of the study reveal that counsellors were expected to give adolescents HIV counselling and testing (HCT) but felt restricted by what they perceived as inflexible standard operating procedures. Counsellors reported inadequate training to address adolescent psychosocial issues during HCT. Healthcare provider attitudes were perceived as a barrier to adolescents using sexual and reproductive health services. Participants strongly recommended augmenting adolescent sexual and reproductive health services to include counsellors and adolescents in developing age- and context-specific HIV prevention services for adolescents. CONCLUSION:Continuous upskilling of HIV counsellors is a critical step in providing adolescent-friendly services. Input from all relevant stakeholders, including counsellors and adolescents, is essential in designing adolescent-friendly services.}, Doi = {10.1186/s12978-018-0455-1}, Key = {fds333034} } @article{fds333643, Author = {Kohrt, BA and Jordans, MJD and Turner, EL and Sikkema, KJ and Luitel, NP and Rai, S and Singla, DR and Lamichhane, J and Lund, C and Patel, V}, Title = {Reducing stigma among healthcare providers to improve mental health services (RESHAPE): protocol for a pilot cluster randomized controlled trial of a stigma reduction intervention for training primary healthcare workers in Nepal.}, Journal = {Pilot and Feasibility Studies}, Volume = {4}, Pages = {36}, Year = {2018}, url = {http://dx.doi.org/10.1186/s40814-018-0234-3}, Abstract = {Background: Non-specialist healthcare providers, including primary and community healthcare workers, in low- and middle-income countries can effectively treat mental illness. However, scaling-up mental health services within existing health systems has been limited by barriers such as stigma against people with mental illness. Therefore, interventions are needed to address attitudes and behaviors among non-specialists. Aimed at addressing this gap, REducing Stigma among HealthcAre Providers to ImprovE mental health services (RESHAPE) is an intervention in which social contact with mental health service users is added to training for non-specialist healthcare workers integrating mental health services into primary healthcare. Methods: This protocol describes a mixed methods pilot and feasibility study in primary care centers in Chitwan, Nepal. The qualitative component will include key informant interviews and focus group discussions. The quantitative component consists of a pilot cluster randomized controlled trial (c-RCT), which will establish parameters for a future effectiveness study of RESHAPE compared to training as usual (TAU). Primary healthcare facilities (the cluster unit, k = 34) will be randomized to TAU or RESHAPE. The direct beneficiaries of the intervention are the primary healthcare workers in the facilities (n = 150); indirect beneficiaries are their patients (n = 100). The TAU condition is existing mental health training and supervision for primary healthcare workers delivered through the Programme for Improving Mental healthcarE (PRIME) implementing the mental health Gap Action Programme (mhGAP). The primary objective is to evaluate acceptability and feasibility through qualitative interviews with primary healthcare workers, trainers, and mental health service users. The secondary objective is to collect quantitative information on health worker outcomes including mental health stigma (Social Distance Scale), clinical knowledge (mhGAP), clinical competency (ENhancing Assessment of Common Therapeutic factors, ENACT), and implicit attitudes (Implicit Association Test, IAT), and patient outcomes including stigma-related barriers to care, daily functioning, and symptoms. Discussion: The pilot and feasibility study will contribute to refining recommendations for implementation of mhGAP and other mental health services in primary healthcare settings in low-resource health systems. The pilot c-RCT findings will inform an effectiveness trial of RESHAPE to advance the evidence-base for optimal approaches to training and supervision for non-specialist providers. Trial registration: ClinicalTrials.gov identifier, NCT02793271.}, Doi = {10.1186/s40814-018-0234-3}, Key = {fds333643} } @article{fds321465, Author = {Watt, MH and Dennis, AC and Choi, KW and Ciya, N and Joska, JA and Robertson, C and Sikkema, KJ}, Title = {Impact of Sexual Trauma on HIV Care Engagement: Perspectives of Female Patients with Trauma Histories in Cape Town, South Africa.}, Journal = {Aids and Behavior}, Volume = {21}, Number = {11}, Pages = {3209-3218}, Year = {2017}, Month = {November}, url = {http://dx.doi.org/10.1007/s10461-016-1617-1}, Abstract = {South African women have disproportionately high rates of both sexual trauma and HIV. To understand how sexual trauma impacts HIV care engagement, we conducted in-depth qualitative interviews with 15 HIV-infected women with sexual trauma histories, recruited from a public clinic in Cape Town. Interviews explored trauma narratives, coping behaviors and care engagement, and transcripts were analyzed using a constant comparison method. Participants reported multiple and complex traumas across their lifetimes. Sexual trauma hindered HIV care engagement, especially immediately following HIV diagnosis, and there were indications that sexual trauma may interfere with future care engagement, via traumatic stress symptoms including avoidance. Disclosure of sexual trauma was limited; no women had disclosed to an HIV provider. Routine screening for sexual trauma in HIV care settings may help to identify individuals at risk of poor care engagement. Efficacious treatments are needed to address the psychological and behavioral sequelae of trauma.}, Doi = {10.1007/s10461-016-1617-1}, Key = {fds321465} } @article{fds327435, Author = {Velloza, J and Watt, MH and Abler, L and Skinner, D and Kalichman, SC and Dennis, AC and Sikkema, KJ}, Title = {HIV-Risk Behaviors and Social Support Among Men and Women Attending Alcohol-Serving Venues in South Africa: Implications for HIV Prevention.}, Journal = {Aids and Behavior}, Volume = {21}, Number = {Suppl 2}, Pages = {144-154}, Year = {2017}, Month = {November}, url = {http://dx.doi.org/10.1007/s10461-017-1853-z}, Abstract = {Alcohol use is associated with increased HIV-risk behaviors, including unprotected sex and number of sex partners. Alcohol-serving venues can be places to engage in HIV-related sexual risk behaviors, but are also important sites of social support for patrons, which may mitigate risks. We sought to examine the relationship between alcohol-serving venue attendance, social support, and HIV-related sexual risk behavior, by gender, in South Africa. Adult patrons (n = 496) were recruited from six alcohol-serving venues and completed surveys assessing frequency of venue attendance, venue-based social support, and recent sexual behaviors. Generalized estimating equations tested associations between daily venue attendance, social support, and sexual behaviors, separately by gender. Interaction effects between daily attendance and social support were assessed. Models were adjusted for venue, age, education, and ethnicity. Daily attendance at venues was similar across genders and was associated with HIV-related risk behaviors, but the strength and direction of associations differed by gender. Among women, daily attendance was associated with greater number of partners and higher proportion of unprotected sex. Social support was a significant moderator, with more support decreasing the strength of the relationship between attendance and risk. Among men, daily attendance was associated with a lower proportion of unprotected sex; no interaction effects were found for attendance and social support. Frequent venue attendance is associated with additional HIV-related risks for women, but this risk is mitigated by social support in venues. These results were not seen for men. Successful HIV interventions in alcohol-serving venues should address the gendered context of social support and sexual risk behavior.}, Doi = {10.1007/s10461-017-1853-z}, Key = {fds327435} } @article{fds320149, Author = {Magidson, JF and Dietrich, J and Otwombe, KN and Sikkema, KJ and Katz, IT and Gray, GE}, Title = {Psychosocial correlates of alcohol and other substance use among low-income adolescents in peri-urban Johannesburg, South Africa: A focus on gender differences.}, Journal = {Journal of Health Psychology}, Volume = {22}, Number = {11}, Pages = {1415-1425}, Year = {2017}, Month = {September}, url = {http://dx.doi.org/10.1177/1359105316628739}, Abstract = {Alcohol and other drug use is prevalent among peri-urban, South African adolescents. We identified correlates of alcohol and other drug use by gender among adolescents (age = 16-18 years; N = 822) in peri-urban Johannesburg. Interviewer-administered surveys assessed sexual activity, alcohol and other drug use, and relevant psychosocial factors. In separate logistic regression models of alcohol and other drug use stratified by gender, violence exposure and sexual activity were associated with alcohol use for both males and females. For females only, depressive symptoms were associated with drug use. For males only, being older and sexually active were associated with drug use. Substance use interventions for South African adolescents should consider psychological health, sexual health, and tailoring by gender.}, Doi = {10.1177/1359105316628739}, Key = {fds320149} } @article{fds332048, Author = {Yemeke, TT and Sikkema, KJ and Watt, MH and Ciya, N and Robertson, C and Joska, JA}, Title = {Screening for Traumatic Experiences and Mental Health Distress Among Women in HIV Care in Cape Town, South Africa.}, Journal = {Journal of Interpersonal Violence}, Pages = {886260517718186}, Year = {2017}, Month = {July}, url = {http://dx.doi.org/10.1177/0886260517718186}, Abstract = {Traumatic events can negatively affect clinical outcomes among HIV positive women, particularly when those events result in ongoing psychological distress. Consequently, there have been calls to integrate screening and treatment of traumatic experiences and associated mental health disorders into HIV care. In South Africa, screening for traumatic experiences and mental health is not a routine part of HIV care. The goal of this study was to examine the prevalence of traumatic experiences and mental health distress among women in an HIV clinic in Cape Town, South Africa, and to explore the acceptability of routine screening in this setting. Seventy HIV positive women were screened following referral from health care workers in the clinic. Among the participants, 51% reported a history of sexual abuse and 75% reported physical intimate partner violence (physical IPV). Among all participants, 36% met screening criteria for depression; among those with traumatic experiences ( n = 57), 70% met screening criteria for posttraumatic stress disorder (PTSD). Compared with reporting no sexual abuse or physical IPV, having experienced both sexual abuse and physical IPV was significantly associated with higher odds of depression, while reporting either sexual abuse or physical IPV individually was not significantly associated with increased odds of depression. Among women reporting sexual abuse, 61% were disclosing their experience for the first time during the screening; 31% of women with physical IPV experience were disclosing for the first time. Overall, 98% of participants thought screening should be routine and extended to all women as part of clinic care. Screening women for sexual abuse and physical IPV may be an important component of ensuring HIV care engagement.}, Doi = {10.1177/0886260517718186}, Key = {fds332048} } @article{fds321676, Author = {Vincent, W and Fang, X and Calabrese, SK and Heckman, TG and Sikkema, KJ and Hansen, NB}, Title = {HIV-related shame and health-related quality of life among older, HIV-positive adults.}, Journal = {Journal of Behavioral Medicine}, Volume = {40}, Number = {3}, Pages = {434-444}, Year = {2017}, Month = {June}, url = {http://dx.doi.org/10.1007/s10865-016-9812-0}, Abstract = {This study investigated how HIV-related shame is associated with health-related quality of life (HRQoL) in older people living with HIV (PLHIV). Structural equation modeling tested whether HIV-related shame was associated with three dimensions of HRQoL (physical, emotional, and social well-being) and whether there were significant indirect associations of HIV-related shame with the three HRQoL dimensions via depression and loneliness in a sample of 299 PLHIV ≥50 years old. Results showed that depression and loneliness were key mechanisms, with depression at least partially accounting for the association between HIV-related shame and both emotional and physical well-being, respectively, and loneliness accounting for the association between HIV-related shame and social well-being. HIV-related shame appears to be an important correlate of HRQoL in older PLHIV and may provide a promising leveraging point by which to improve HRQoL in older PLHIV.}, Doi = {10.1007/s10865-016-9812-0}, Key = {fds321676} } @article{fds323693, Author = {Choi, KW and Sikkema, KJ and Vythilingum, B and Geerts, L and Faure, SC and Watt, MH and Roos, A and Stein, DJ}, Title = {Maternal childhood trauma, postpartum depression, and infant outcomes: Avoidant affective processing as a potential mechanism.}, Journal = {Journal of Affective Disorders}, Volume = {211}, Pages = {107-115}, Year = {2017}, Month = {March}, url = {http://dx.doi.org/10.1016/j.jad.2017.01.004}, Abstract = {BACKGROUND:Women who have experienced childhood trauma may be at risk for postpartum depression, increasing the likelihood of negative outcomes among their children. Predictive pathways from maternal childhood trauma to child outcomes, as mediated by postpartum depression, require investigation. METHODS:A longitudinal sample of South African women (N=150) was followed through pregnancy and postpartum. Measures included maternal trauma history reported during pregnancy; postpartum depression through six months; and maternal-infant bonding, infant development, and infant physical growth at one year. Structural equation models tested postpartum depression as a mediator between maternal experiences of childhood trauma and children's outcomes. A subset of women (N=33) also participated in a lab-based emotional Stroop paradigm, and their responses to fearful stimuli at six weeks were explored as a potential mechanism linking maternal childhood trauma, postpartum depression, and child outcomes. RESULTS:Women with childhood trauma experienced greater depressive symptoms through six months postpartum, which then predicted negative child outcomes at one year. Mediating effects of postpartum depression were significant, and persisted for maternal-infant bonding and infant growth after controlling for covariates and antenatal distress. Maternal avoidance of fearful stimuli emerged as a potential affective mechanism. LIMITATIONS:Limitations included modest sample size, self-report measures, and unmeasured potential confounders. CONCLUSIONS:Findings suggest a mediating role of postpartum depression in the intergenerational transmission of negative outcomes. Perinatal interventions that address maternal trauma histories and depression, as well as underlying affective mechanisms, may help interrupt cycles of disadvantage, particularly in high-trauma settings such as South Africa.}, Doi = {10.1016/j.jad.2017.01.004}, Key = {fds323693} } @article{fds329106, Author = {Watt, MH and Mosha, MV and Platt, AC and Sikkema, KJ and Wilson, SM and Turner, EL and Masenga, GG}, Title = {A nurse-delivered mental health intervention for obstetric fistula patients in Tanzania: results of a pilot randomized controlled trial.}, Journal = {Pilot and Feasibility Studies}, Volume = {3}, Pages = {35}, Year = {2017}, Month = {January}, url = {http://dx.doi.org/10.1186/s40814-017-0178-z}, Abstract = {Obstetric fistula has severe psychological consequences, but no evidence-based interventions exist to improve mental health in this population. This pilot trial evaluated a psychological intervention for women receiving surgical care for obstetric fistula.A parallel two-armed pilot RCT was conducted between 2014 and 2016. The intervention was six individual sessions, based on psychological theory and delivered by a nurse facilitator. The study was conducted at a tertiary hospital in Moshi, Tanzania. Women were eligible if they were over age 18 and admitted to the hospital for surgical repair of an obstetric fistula. Sixty participants were randomized to the intervention or standard of care. Surveys were completed at baseline, post-treatment (before discharge), and 3 months following discharge. Standardized scales measured depression, anxiety, traumatic stress, and self-esteem. Feasibility of an RCT was assessed by participation and retention. Feasibility and acceptability of the intervention were assessed by fidelity, attendance, and participant ratings. Potential efficacy was assessed by exploratory linear regression and clinical significance analysis.Eighty-five percent met criteria for mental health dysfunction at enrollment. All eligible patients enrolled, with retention 100% post and 73% at 3 months. Participants rated the intervention acceptable and beneficial. There were sharp and meaningful improvements in mental health outcomes over time, with no evidence of differences by condition.A nurse-delivered mental health intervention was feasible to implement as part of in-patient clinical care and regarded positively. Mental health treatment in this population is warranted given high level of distress at presentation to care.ClinicalTrials.Gov NCT01934075.}, Doi = {10.1186/s40814-017-0178-z}, Key = {fds329106} } @article{fds253903, Author = {Choi, KW and Sikkema, KJ}, Title = {Childhood Maltreatment and Perinatal Mood and Anxiety Disorders: A Systematic Review.}, Journal = {Trauma, Violence & Abuse}, Volume = {17}, Number = {5}, Pages = {427-453}, Year = {2016}, Month = {December}, ISSN = {1524-8380}, url = {http://dx.doi.org/10.1177/1524838015584369}, Abstract = {Perinatal mood and anxiety disorders (PMADs) compromise maternal and child well-being and may be influenced by traumatic experiences across the life course. A potent and common form of trauma is childhood maltreatment, but its specific impact on PMADs is not well understood. A systematic review was undertaken to synthesize empirical literature on the relationship between maternal histories of childhood maltreatment and PMADs. Of the 876 citations retrieved, 35 reports from a total of 26,239 participants met inclusion criteria, documenting substantial rates of childhood maltreatment and PMADs. Robust trends of association were observed between childhood maltreatment and perinatal depression, as well as post-traumatic stress disorder, but findings for anxiety were less consistent. Examining multivariate results suggested that childhood maltreatment predicts PMADs above and beyond sociodemographic, psychiatric, perinatal, and psychosocial factors, but may also be partially mediated by variables such as later victimization and moderated by protective early relationships. Future research should test mediating and moderating pathways using prospective cohorts, expanding to cross-cultural settings and other disorder outcomes. Treatment and prevention of childhood maltreatment and its sequelae may help mitigate risk for perinatal psychopathology and its impact on maternal and child outcomes.}, Doi = {10.1177/1524838015584369}, Key = {fds253903} } @article{fds320147, Author = {Willie, TC and Overstreet, NM and Peasant, C and Kershaw, T and Sikkema, KJ and Hansen, NB}, Title = {Anxiety and Depressive Symptoms Among People Living with HIV and Childhood Sexual Abuse: The Role of Shame and Posttraumatic Growth.}, Journal = {Aids and Behavior}, Volume = {20}, Number = {8}, Pages = {1609-1620}, Year = {2016}, Month = {August}, url = {http://dx.doi.org/10.1007/s10461-016-1298-9}, Abstract = {There is a critical need to examine protective and risk factors of anxiety and depressive symptoms among people living with HIV in order to improve quality of life. Structural equation modeling was used to examine the associations between HIV-related shame, sexual abuse-related shame, posttraumatic growth, and anxiety and depressive symptoms among a cohort of 225 heterosexual women and men who have sex with men (MSM) living with HIV who have experienced childhood sexual abuse (CSA). Higher sexual abuse-related shame was related to more anxiety and depressive symptoms for heterosexual women. Higher posttraumatic growth predicted less anxiety symptoms for only heterosexual women. Higher posttraumatic growth predicted less depressive symptoms for heterosexual women and MSM, but the magnitude of this effect was stronger for heterosexual women than MSM. Psychosocial interventions may need to be tailored to meet the specific needs of heterosexual women and MSM living with HIV and CSA.}, Doi = {10.1007/s10461-016-1298-9}, Key = {fds320147} } @article{fds320148, Author = {Puffer, ES and Green, EP and Sikkema, KJ and Broverman, SA and Ogwang-Odhiambo, RA and Pian, J}, Title = {A church-based intervention for families to promote mental health and prevent HIV among adolescents in rural Kenya: Results of a randomized trial.}, Journal = {Journal of Consulting and Clinical Psychology}, Volume = {84}, Number = {6}, Pages = {511-525}, Year = {2016}, Month = {June}, url = {http://dx.doi.org/10.1037/ccp0000076}, Abstract = {OBJECTIVE:To evaluate a family- and church-based intervention for adolescents and caregivers in rural Kenya to improve family relationships, reduce HIV risk, and promote mental health. METHOD:The intervention was developed using community-based participatory methods and focused on strengthening family communication. Modules addressed economic, relationship, and HIV-related topics using evidence-based behavioral strategies alongside culturally grounded content. A stepped wedge cluster randomized trial was conducted with 124 families (237 adolescents ages 10 to 16; 203 caregivers) from 4 churches. Participants completed interviewer-administered surveys over 5 rounds. Primary outcomes included family communication, HIV risk knowledge, self-efficacy, and beliefs. Secondary outcomes included parenting, social support, mental health, and adolescent sexual behavior. We estimated intent-to-treat effects via ordinary least squares regression with clustered standard errors. RESULTS:Relative to controls, the intervention group reported better family communication across domains at 1- and 3-months postintervention and higher self-efficacy for risk reduction skills and HIV-related knowledge at 1-month postintervention. Sexually active youth in the intervention reported fewer high-risk behaviors at 1-month postintervention, including unprotected sex or multiple partners. Male caregivers in the intervention reported higher parental involvement at both time points, and youth reported more social support from male caregivers at 3-months postintervention. No effects on secondary outcomes of parenting, social support, and mental health were detected. CONCLUSIONS:This intervention holds promise for strengthening positive family processes to protect against negative future outcomes for adolescents. Implementation with religious congregations may be a promising strategy for improving sustainability and scalability of interventions in low-resource settings. (PsycINFO Database Record}, Doi = {10.1037/ccp0000076}, Key = {fds320148} } @article{fds318784, Author = {Wilson, SM and Sikkema, KJ and Watt, MH and Masenga, GG and Mosha, MV}, Title = {Psychological Symptoms and Social Functioning Following Repair of Obstetric Fistula in a Low-Income Setting.}, Journal = {Matern Child Health J}, Volume = {20}, Number = {5}, Pages = {941-945}, Year = {2016}, Month = {May}, url = {http://dx.doi.org/10.1007/s10995-016-1950-z}, Abstract = {Objectives Obstetric fistula is a maternal injury that causes uncontrollable leaking of urine or stool, and most women who develop it live in poverty in low-income countries. Obstetric fistula is associated with high rates of stigma and psychological morbidity, but there is uncertainty about the impact of surgical treatment on psychological outcomes. The objective of this exploratory study was to examine changes in psychological symptoms following surgical fistula repair, discharge and reintegration home. Methods Women admitted for surgical repair of obstetric fistula were recruited from a Tanzanian hospital serving a rural catchment area. Psychological symptoms and social functioning were assessed prior to surgery. Approximately 3 months after discharge, a data collector visited the patients' homes to repeat psychosocial measures and assess self-reported incontinence. Baseline to follow-up differences were measured with paired t tests controlling for multiple comparisons. Associations between psychological outcomes and leaking were assessed with t tests and Pearson correlations. Results Participants (N = 28) had been living with fistula for an average of 11 years. Baseline psychological distress was high, and decreased significantly at follow-up. Participants who self-reported continued incontinence at follow-up endorsed significantly higher PTSD and depression symptoms than those who reported being cured, and severity of leaking was associated with psychological distress. Conclusions Fistula patients experience improvements in mental health at 3 months after discharge, but these improvements are curtailed when women experience residual leaking. Given the rate of stress incontinence following surgery, it is important to prepare fistula patients for the possibility of incomplete cure and help them develop appropriate coping strategies.}, Doi = {10.1007/s10995-016-1950-z}, Key = {fds318784} } @article{fds253902, Author = {Willie, TC and Overstreet, NM and Sullivan, TP and Sikkema, KJ and Hansen, NB}, Title = {Barriers to HIV Medication Adherence: Examining Distinct Anxiety and Depression Symptoms among Women Living with HIV Who Experienced Childhood Sexual Abuse.}, Journal = {Behavioral Medicine (Washington, D.C.)}, Volume = {42}, Number = {2}, Pages = {120-127}, Year = {2016}, Month = {April}, ISSN = {0896-4289}, url = {http://dx.doi.org/10.1080/08964289.2015.1045823}, Abstract = {Experiencing sexual violence in childhood or adolescence is highly prevalent among some women living with HIV, often resulting in anxiety and depression symptoms in adulthood. Anxiety and depression have been associated with HIV medication nonadherence, yet little research has assessed distinct components of anxiety and depression as risk factors of HIV medication nonadherence. The current study examined distinct symptom components of anxiety and depression as predictors of HIV medication non-adherence among women living with HIV and childhood sexual abuse enrolled in a coping intervention. This secondary analysis included a sample of 85 women living with HIV and childhood sexual abuse and being prescribed antiretroviral medication who completed measures on anxiety, depression, and medication adherence. Results from a logistic regression analysis suggest that distinct components of anxiety may be related to medication nonadherence among this population. Targeted mental health interventions for this population may increase adherence to antiretroviral medication.}, Doi = {10.1080/08964289.2015.1045823}, Key = {fds253902} } @article{fds253888, Author = {Watt, MH and Eaton, LA and Dennis, AC and Choi, KW and Kalichman, SC and Skinner, D and Sikkema, KJ}, Title = {Alcohol Use During Pregnancy in a South African Community: Reconciling Knowledge, Norms, and Personal Experience.}, Journal = {Maternal and Child Health Journal}, Volume = {20}, Number = {1}, Pages = {48-55}, Year = {2016}, Month = {January}, ISSN = {1092-7875}, url = {http://dx.doi.org/10.1007/s10995-015-1800-4}, Abstract = {OBJECTIVES:Due to high rates of fetal alcohol spectrum disorder (FASD) in South Africa, reducing alcohol use during pregnancy is a pressing public health priority. The aim of this study was to qualitatively explore knowledge and attitudes about maternal alcohol consumption among women who reported alcohol use during pregnancy. METHODS:The study was conducted in Cape Town, South Africa. Participants were pregnant or within 1 year postpartum and self-reported alcohol use during pregnancy. In-depth interviews explored personal experiences with drinking during pregnancy, community norms and attitudes towards maternal drinking, and knowledge about FASD. Transcripts were analyzed using a content analytic approach, including narrative memos and data display matrices. RESULTS:Interviews revealed competing attitudes. Women received anti-drinking messages from several sources, but these sources were not highly valued and the messages often contradicted social norms. Women were largely unfamiliar with FASD, and their knowledge of impacts of fetal alcohol exposure was often inaccurate. Participants' personal experiences influenced their attitudes about the effects of alcohol during pregnancy, which led to internalization of misinformation. The data revealed a moral conflict that confronted women in this setting, leaving women feeling judged, ambivalent, or defensive about their behaviors, and ultimately creating uncertainty about their alcohol use behaviors. CONCLUSIONS:Data revealed the need to deliver accurate information about the harms of fetal alcohol exposure through sources perceived as trusted and reliable. Individual-level interventions to help women reconcile competing attitudes and identify motivations for reducing alcohol use during pregnancy would be beneficial.}, Doi = {10.1007/s10995-015-1800-4}, Key = {fds253888} } @article{fds318783, Author = {Skalski, LM and Towe, SL and Sikkema, KJ and Meade, CS}, Title = {The Impact of Marijuana Use on Memory in HIV-Infected Patients: A Comprehensive Review of the HIV and Marijuana Literatures.}, Journal = {Curr Drug Abuse Rev}, Volume = {9}, Number = {2}, Pages = {126-141}, Year = {2016}, url = {http://dx.doi.org/10.2174/1874473709666160502124503}, Abstract = {BACKGROUND: The most robust neurocognitive effect of marijuana use is memory impairment. Memory deficits are also high among persons living with HIV/AIDS, and marijuana is the most commonly used drug in this population. Yet research examining neurocognitive outcomes resulting from co-occurring marijuana and HIV is limited. OBJECTIVE: The primary objectives of this comprehensive review are to: (1) examine the literature on memory functioning in HIV-infected individuals; (2) examine the literature on memory functioning in marijuana users; (3) synthesize findings and propose a theoretical framework to guide future research. METHOD: PubMed was searched for English publications 2000-2013. Twenty-two studies met inclusion criteria in the HIV literature, and 23 studies in the marijuana literature. RESULTS: Among HIV-infected individuals, memory deficits with medium to large effect sizes were observed. Marijuana users also demonstrated memory problems, but results were less consistent due to the diversity of samples. CONCLUSION: A compensatory hypothesis, based on the cognitive aging literature, is proposed to provide a framework to explore the interaction between marijuana and HIV. There is some evidence that individuals infected with HIV recruit additional brain regions during memory tasks to compensate for HIV-related declines in neurocognitive functioning. Marijuana is associated with disturbance in similar brain systems, and thus it is hypothesized that the added neural strain of marijuana can exhaust neural resources, resulting in pronounced memory impairment. It will be important to test this hypothesis empirically, and future research priorities are discussed.}, Doi = {10.2174/1874473709666160502124503}, Key = {fds318783} } @article{fds320150, Author = {Dennis, AC and Wilson, SM and Mosha, MV and Masenga, GG and Sikkema, KJ and Terroso, KE and Watt, MH}, Title = {Experiences of social support among women presenting for obstetric fistula repair surgery in Tanzania.}, Journal = {International Journal of Women'S Health}, Volume = {8}, Pages = {429-439}, Year = {2016}, url = {http://dx.doi.org/10.2147/IJWH.S110202}, Abstract = {OBJECTIVE: An obstetric fistula is a childbirth injury resulting in uncontrollable leakage of urine and/or feces and can lead to physical and psychological challenges, including social isolation. Prior to and after fistula repair surgery, social support can help a woman to reintegrate into her community. The aim of this study was to preliminarily examine the experiences of social support among Tanzanian women presenting with obstetric fistula in the periods immediately preceding obstetric fistula repair surgery and following reintegration. PATIENTS AND METHODS: The study used a mixed-methods design to analyze cross-sectional surveys (n=59) and in-depth interviews (n=20). RESULTS: Women reported widely varying levels of social support from family members and partners, with half of the sample reporting overall high levels of social support. For women experiencing lower levels of support, fistula often exacerbated existing problems in relationships, sometimes directly causing separation or divorce. Many women were assertive and resilient with regard to advocating for their fistula care and relationship needs. CONCLUSION: Our data suggest that while some women endure negative social experiences following an obstetric fistula and require additional resources and services, many women report high levels of social support from family members and partners, which may be harnessed to improve the holistic care for patients.}, Doi = {10.2147/IJWH.S110202}, Key = {fds320150} } @article{fds253886, Author = {Wilson, SM and Sikkema, KJ and Watt, MH and Masenga, GG}, Title = {Psychological Symptoms Among Obstetric Fistula Patients Compared to Gynecology Outpatients in Tanzania.}, Journal = {International Journal of Behavioral Medicine}, Volume = {22}, Number = {5}, Pages = {605-613}, Year = {2015}, Month = {October}, ISSN = {1070-5503}, url = {http://dx.doi.org/10.1007/s12529-015-9466-2}, Abstract = {BACKGROUND: Obstetric fistula is a childbirth injury prevalent in sub-Saharan Africa that causes uncontrollable leaking of urine and/or feces. Research has documented the social and psychological sequelae of obstetric fistula, including mental health dysfunction and social isolation. PURPOSE: This cross-sectional study sought to quantify the psychological symptoms and social support in obstetric fistula patients, compared with a patient population of women without obstetric fistula. METHOD: Participants were gynecology patients (N = 144) at the Kilimanjaro Christian Medical Center in Moshi, Tanzania, recruited from the Fistula Ward (n = 54) as well as gynecology outpatient clinics (n = 90). Measures included previously validated psychometric questionnaires, administered orally by Tanzanian nurses. Outcome variables were compared between obstetric fistula patients and gynecology outpatients, controlling for background demographic variables and multiple comparisons. RESULTS: Compared to gynecology outpatients, obstetric fistula patients reported significantly higher symptoms of depression, post-traumatic stress disorder, somatic complaints, and maladaptive coping. They also reported significantly lower social support. CONCLUSION: Obstetric fistula patients present for repair surgery with more severe psychological distress than gynecology outpatients. In order to address these mental health concerns, clinicians should engage obstetric fistula patients with targeted mental health interventions.}, Doi = {10.1007/s12529-015-9466-2}, Key = {fds253886} } @article{fds253922, Author = {Velloza, J and Watt, MH and Choi, KW and Abler, L and Kalichman, SC and Skinner, D and Pieterse, D and Sikkema, KJ}, Title = {HIV/AIDS-related stigma in South African alcohol-serving venues and its potential impact on HIV disclosure, testing and treatment-seeking behaviours.}, Journal = {Global Public Health}, Volume = {10}, Number = {9}, Pages = {1092-1106}, Year = {2015}, Month = {October}, ISSN = {1744-1692}, url = {http://dx.doi.org/10.1080/17441692.2014.1001767}, Abstract = {Alcohol-serving venues in South Africa are sites for high-risk behaviours that may lead to HIV transmission. Prevention and treatment interventions are sorely needed in these settings, but HIV-related stigma may limit their effectiveness. This study explored expressions of stigma among alcohol-serving venue patrons in Cape Town and examined the potential impact of stigma on HIV disclosure, testing and treatment-seeking behaviours. A total of 92 in-depth interviews with male and female, black and coloured patrons were conducted. Transcripts were analysed via memo-writing and diagramming techniques. Many participants mentioned knowing other patrons living with HIV/AIDS (PLWH), and this visibility of HIV impacted expressions of HIV-related stigma. Participants discussed four forms of HIV-related stigma in the venues: fearing PLWH, fearing HIV acquisition, blaming others for spreading HIV and isolating PLWH. HIV visibility and expressions of HIV-related stigma, particularly fear of isolation, influenced participants' willingness to disclose their status. HIV-related stigma in the venues also appeared to indirectly influence testing and treatment-seeking behaviour outside the venue. Results suggest that efforts to change norms and reduce expressions of HIV-related stigma in alcohol-serving venues are necessary to successfully deliver tailored HIV prevention interventions and increase uptake of HIV testing and care in this important social setting.}, Doi = {10.1080/17441692.2014.1001767}, Key = {fds253922} } @article{fds253924, Author = {Choi, KW and Sikkema, KJ and Velloza, J and Marais, A and Jose, C and Stein, DJ and Watt, MH and Joska, JA}, Title = {Maladaptive coping mediates the influence of childhood trauma on depression and PTSD among pregnant women in South Africa.}, Journal = {Archives of Women'S Mental Health}, Volume = {18}, Number = {5}, Pages = {731-738}, Year = {2015}, Month = {October}, ISSN = {1434-1816}, url = {http://dx.doi.org/10.1007/s00737-015-0501-8}, Abstract = {Antenatal mental disorders compromise maternal and child health, and women who have experienced childhood trauma may be at increased risk for such disorders. One hypothesis is that early trauma leads to the development and use of maladaptive coping strategies as an adult, which in turn could predict mental health difficulties during stressful transitions such as pregnancy. To test this hypothesis, this study examined the relationship between childhood trauma and mental health (depression, PTSD) in a sample of 84 pregnant women seeking antenatal care in Cape Town, South Africa, and explored whether maladaptive coping mediated this relationship. The majority of women (62 %) met established criteria for antenatal depression and 30 % for antenatal PTSD; in addition, 40 % reported a history of childhood trauma. Childhood trauma, especially childhood sexual abuse and emotional abuse, was significantly associated with depression and PTSD. The relationships between childhood trauma and depression and PTSD were significantly mediated by maladaptive coping, even when adjusted for the woman's age, gestational age, and HIV status. Findings highlight the need for coping-based interventions to prevent and treat antenatal mental disorders among women with childhood trauma, particularly in high-trauma settings such as South Africa.}, Doi = {10.1007/s00737-015-0501-8}, Key = {fds253924} } @article{fds253906, Author = {Skalski, LM and Watt, MH and MacFarlane, JC and Proeschold-Bell, RJ and Stout, JE and Sikkema, KJ}, Title = {Mental Health and Substance Use Among Patients in a North Carolina HIV Clinic.}, Journal = {North Carolina Medical Journal}, Volume = {76}, Number = {3}, Pages = {148-155}, Year = {2015}, Month = {July}, ISSN = {0029-2559}, url = {http://hdl.handle.net/10161/10742 Duke open access}, Abstract = {BACKGROUND: The HIV/AIDS epidemic is a significant public health concern in North Carolina, and previous research has pointed to elevated mental health distress and substance use among HIV-infected populations, which may impact patients' adherence to medications. The aims of this study were to describe the prevalence of mental health and substance use issues among patients of a North Carolina HIV clinic, to examine differences by demographic characteristics, and to examine factors associated with suboptimal adherence to HIV medications. METHODS: This study was a secondary analysis of clinical data routinely collected through a health behavior questionnaire at a large HIV clinic in North Carolina. We analyzed data collected from February 2011 to August 2012. RESULTS: The sample included 1,398 patients. Overall, 12.2% of patients endorsed current symptomology indicative of moderate or severe levels of depression, and 38.6% reported receiving a psychiatric diagnosis at some point in their life. Additionally, 19.1% had indications of current problematic drinking, and 8.2% reported problematic drug use. Nearly one-quarter (22.1%) reported suboptimal adherence to HIV medications. Factors associated with poor adherence included racial/ethnic minority, age less than 35 years, and indications of moderate or severe depression. LIMITATIONS: The questionnaire was not completed systematically in the clinic, which may limit generalizability, and self-reported measures may have introduced social desirability bias. CONCLUSION: Patients were willing to disclose mental health distress, substance use, and suboptimal medication adherence to providers, which highlights the importance of routinely assessing these behaviors during clinic visits. Our findings suggest that treating depression may be an effective strategy to improve adherence to HIV medications.}, Doi = {10.18043/ncm.76.3.148}, Key = {fds253906} } @article{fds253920, Author = {Watt, MH and Wilson, SM and Sikkema, KJ and Velloza, J and Mosha, MV and Masenga, GG and Bangser, M and Browning, A and Nyindo, PM}, Title = {Development of an intervention to improve mental health for obstetric fistula patients in Tanzania.}, Journal = {Eval Program Plann}, Volume = {50}, Pages = {1-9}, Year = {2015}, Month = {June}, ISSN = {0149-7189}, url = {http://dx.doi.org/10.1016/j.evalprogplan.2015.01.007}, Abstract = {Obstetric fistula is a debilitating childbirth injury that has been associated with high rates of psychological distress. Global efforts have helped to link women to surgical repair, but thus far no evidence-based interventions exist to address the psychological needs of these women during the hospital stay. In this paper, we describe the development of a psychological intervention for women in Tanzania who are receiving surgical care for an obstetric fistula. The intervention was developed based on theories of cognitive behavioral therapy and coping models. Content and delivery were informed by qualitative data collection with a range of stakeholders including women with fistula, and input from a study advisory board. The resulting intervention was six individual sessions, delivered by a trained community health nurse. The session topics were (1) recounting the fistula story; (2) creating a new story about the fistula; (3) loss, grief and shame; (4) specific strategies for coping; (5) social relationships; and (6) planning for the future. A trial run of the intervention revealed that the intervention could be delivered with fidelity and was acceptable to patients. A future randomized control trial will evaluate the efficacy of this intervention to address the mental health symptoms of this population.}, Doi = {10.1016/j.evalprogplan.2015.01.007}, Key = {fds253920} } @article{fds253927, Author = {Watt, MH and Sikkema, KJ and Abler, L and Velloza, J and Eaton, LA and Kalichman, SC and Skinner, D and Pieterse, D}, Title = {Experiences of forced sex among female patrons of alcohol-serving venues in a South African township.}, Journal = {Journal of Interpersonal Violence}, Volume = {30}, Number = {9}, Pages = {1533-1552}, Year = {2015}, Month = {May}, ISSN = {0886-2605}, url = {http://dx.doi.org/10.1177/0886260514540807}, Abstract = {South Africa has among the highest rates of forced sex worldwide, and alcohol use has consistently been associated with risk of forced sex in South Africa. However, methodological challenges affect the accuracy of forced sex measurements. This study explored the assessment of forced sex among South African women attending alcohol-serving venues and identified factors associated with reporting recent forced sex. Women (n = 785) were recruited from 12 alcohol-serving venues in a peri-urban township in Cape Town. Brief self-administered surveys included questions about lifetime and recent experiences of forced sex. Surveys included a single question about forced sex and detailed questions about sex by physical force, threats, verbal persuasion, trickery, and spiked drinks. We first compared the single question about forced sex to a composite variable of forced sex as unwanted sex by physical force, threats, or spiked drinks. We then examined potential predictors of recent forced sex (demographics, drinking behavior, relationship to the venue, abuse experiences). The single question about forced sex had low sensitivity (0.38); more than half of the respondents who reported on the detailed questions that they had experienced forced sex by physical force, threats, or spiked drinks reported on the single question item that they had not experienced forced sex. Using our composite variable, 18.6% of women reported lifetime and 10.8% reported recent experiences of forced sex. In our adjusted logistic regression model, recent forced sex using the composite variable was significantly associated with hazardous drinking (OR = 1.92), living farther from the venue (OR = 1.81), recent intimate partner violence (OR = 2.53), and a history of childhood sexual abuse (OR = 4.35). The findings support the need for additional work to refine the assessment of forced sex. Efforts to prevent forced sex should target alcohol-serving venues, where norms and behaviors may present particular risks for women who frequent these settings.}, Doi = {10.1177/0886260514540807}, Key = {fds253927} } @article{fds303806, Author = {Sikkema, KJ and Puffer, E and MacFarlane, J}, Title = {Family interventions}, Booktitle = {Encyclopedia of AIDS}, Publisher = {SPRINGER}, Editor = {Hope, T and Richman, D and Stevenson, M}, Year = {2015}, Month = {April}, Key = {fds303806} } @article{fds303808, Author = {Sikkema, KJ and Khunwane, MN and Dietrich, J and Coetzee, J and deBruyn, G and Nikala, B and Gray, G}, Title = {Counselors and key stakeholders' perceptions of HIV counseling and testing for adolescents in Soweto, South Africa}, Journal = {Bmc Health Services Research}, Publisher = {BioMed Central}, Year = {2015}, Month = {April}, ISSN = {1472-6963}, Key = {fds303808} } @article{fds253925, Author = {Abler, L and Sikkema, KJ and Watt, MH and Pitpitan, EV and Kalichman, SC and Skinner, D and Pieterse, D}, Title = {Traumatic stress and the mediating role of alcohol use on HIV-related sexual risk behavior: results from a longitudinal cohort of South African women who attend alcohol-serving venues.}, Journal = {Journal of Acquired Immune Deficiency Syndromes}, Volume = {68}, Number = {3}, Pages = {322-328}, Year = {2015}, Month = {March}, ISSN = {1525-4135}, url = {http://dx.doi.org/10.1097/qai.0000000000000433}, Abstract = {In South Africa, alcohol contributes to the HIV epidemic, in part, by influencing sexual behaviors. For some, high levels of alcohol consumption may be driven by previous traumatic experiences that result in traumatic stress. The purpose of this study was to quantify the longitudinal association between traumatic stress and unprotected sex among women who attend drinking venues and to assess whether this association was explained by mediation through alcohol use.Data were collected in 4 waves over a year from a prospective cohort of 560 women who regularly attended alcohol-serving venues in a Cape Town township. Longitudinal mixed models examined (1) the relationship between traumatic stress and counts of unprotected sex and (2) whether alcohol use mediated the association between traumatic stress and unprotected sex.Most women reported elevated traumatic stress (80%) and hazardous alcohol use (88%) at least once during the study period. In models adjusted for covariates, traumatic stress was associated with unprotected sex (b = 0.28, SE = 0.06, t = 4.82, P < 0.001). In addition, traumatic stress was associated with alcohol use (b = 0.27, SE = 0.02, t = 14.25, P < 0.001) and was also associated with unprotected sex (b = 0.20, SE = 0.06, t = 3.27, P < 0.01) while controlling for alcohol use (b = 0.28, SE = 0.07, t = 4.25, P < 0.001). The test for the mediated effect established that alcohol use was a significant mediator, accounting for 27% of the total effect of traumatic stress on unprotected sex.These results highlight the need to address traumatic stress among female venue patrons as an important precursor of HIV risk due to alcohol use.}, Doi = {10.1097/qai.0000000000000433}, Key = {fds253925} } @article{fds253885, Author = {Sikkema, KJ and Dennis, AC and Watt, MH and Choi, KW and Yemeke, TT and Joska, JA}, Title = {Improving mental health among people living with HIV: a review of intervention trials in low- and middle-income countries.}, Journal = {Global Mental Health (Cambridge, England)}, Volume = {2}, Year = {2015}, Month = {January}, url = {http://hdl.handle.net/10161/10741 Duke open access}, Abstract = {People living with HIV (PLWH) experience greater psychological distress than the general population. Evidence from high-incomes countries suggests that psychological interventions for PLWH can improve mental health symptoms, quality of life, and HIV care engagement. However, little is known about the effectiveness of mental health interventions for PLWH in low and middle-income countries (LMICs), where the large majority of PLWH reside. This systematized review aims to synthesize findings from mental health intervention trials with PLWH in LMICs to inform the delivery of mental health services in these settings. A systematic search strategy was undertaken to identify peer-reviewed published papers of intervention trials addressing negative psychological states or disorders (e.g., depression, anxiety) among PLWH in LMIC settings. Search results were assessed against pre-established inclusion and exclusion criteria. Data from papers meeting criteria were extracted for synthesis. Twenty-six papers, published between 2000 and 2014, describing 22 unique interventions were identified. Trials were implemented in sub-Saharan Africa (n=13), Asia (n=7), and the Middle East (n=2), and addressed mental health using a variety of approaches, including cognitive-behavioral (n=18), family-level (n=2), and pharmacological (n=2) treatments. Four randomized controlled trials reported significant intervention effects in mental health outcomes, and eleven preliminary studies demonstrated promising findings. Among the limited mental health intervention trials with PLWH in LMICs, few demonstrated efficacy. Mental health interventions for PLWH in LMICs must be further developed and adapted for resource-limited settings to improve effectiveness.}, Doi = {10.1017/gmh.2015.17}, Key = {fds253885} } @article{fds253887, Author = {Fang, X and Vincent, W and Calabrese, SK and Heckman, TG and Sikkema, KJ and Humphries, DL and Hansen, NB}, Title = {Resilience, stress, and life quality in older adults living with HIV/AIDS.}, Journal = {Aging & Mental Health}, Volume = {19}, Number = {11}, Pages = {1015-1021}, Year = {2015}, Month = {January}, ISSN = {1360-7863}, url = {http://dx.doi.org/10.1080/13607863.2014.1003287}, Abstract = {OBJECTIVES:This study tested the mediating effect of resilience on the relationship between life stress and health-related quality of life (HRQoL) in older people, 50 years of age and older, living with HIV/AIDS (OPLWHA). METHOD:Data from 299 OPLWHA were analyzed using structural equation modeling (SEM) to define a novel resilience construct (represented by coping self-efficacy, active coping, hope/optimism, and social support) and to assess mediating effects of resilience on the association between life stress and HRQoL (physical, emotional, and functional/global well-being). RESULTS:SEM analyses showed satisfactory model fit for both resilience and mediational models, with resilience mediating the associations between life stress and physical, emotional, and functional/global well-being. CONCLUSION:Resilience may reduce the negative influence of life stress on physical, emotional, and functional/global well-being in OPLWHA. Interventions that build personal capacity, coping skills, and social support may contribute to better management of HIV/AIDS and increase HRQoL.}, Doi = {10.1080/13607863.2014.1003287}, Key = {fds253887} } @article{fds253889, Author = {Otwombe, KN and Dietrich, J and Sikkema, KJ and Coetzee, J and Hopkins, KL and Laher, F and Gray, GE}, Title = {Exposure to and experiences of violence among adolescents in lower socio-economic groups in Johannesburg, South Africa.}, Journal = {Bmc Public Health}, Volume = {15}, Pages = {450}, Year = {2015}, Month = {January}, url = {http://dx.doi.org/10.1186/s12889-015-1780-8}, Abstract = {We explored exposure to and experiences of violence and their risk factors amongst ethnically diverse adolescents from lower socio economic groups in Johannesburg.This cross-sectional study recruited a stratified sample of 16-18 year old adolescents from four low socio-economic suburbs in Johannesburg to reflect ethnic group clustering. We collected socio-demographic, sexual behaviour, alcohol and drug use and trauma events data. Proportions and risk factors were assessed by chi-square and logistic regression.Of 822 adolescents, 57% (n = 469) were female. Approximately 62% (n = 506) were Black, 13% (n = 107) Coloured, 13% (n = 106) Indian and 13% (n = 103) White. Approximately 67% (n = 552) witnessed violence to a non-family member, 28% (n = 228) experienced violence by a non-family member, and 10% (n = 83) reported sexual abuse. Multivariate analysis determined that witnessing violence in the community was associated with being Black (OR: 4.6, 95%CI: 2.7-7.9), Coloured (OR: 3.9, 95%CI: 2.0-7.4) or White (OR: 8.0, 95%CI:4.0-16.2), repeating a grade (OR: 1.5, 95%CI: 1.01-2.1), having more than one sexual partner (OR: 1.7, 95%CI: 1.1-2.5) and ever taking alcohol (OR: 2.1, 95%CI: 1.5-2.9). Witnessing violence in the family was associated with being female (OR: 1.8, 95%CI: 1.3-2.6), being Black (OR: 2.2, 95%CI: 1.1-4.1), or White (OR: 3.0, 95%CI: 1.4-6.4), repeating a grade (OR: 1.6, 95%CI: 1.1-2.2) and ever taking alcohol (OR: 2.9, 95%CI: 2.0-4.3).In low socio-economic areas in Johannesburg, Black, White and Coloured adolescents experience a high burden of violence. Interventions to mitigate the effects of violence are urgently required.}, Doi = {10.1186/s12889-015-1780-8}, Key = {fds253889} } @article{fds253935, Author = {Lovejoy, TI and Heckman, TG and Sikkema, KJ and Hansen, NB and Kochman, A}, Title = {Changes in sexual behavior of HIV-infected older adults enrolled in a clinical trial of standalone group psychotherapies targeting depression.}, Journal = {Aids and Behavior}, Volume = {19}, Number = {1}, Pages = {1-8}, Year = {2015}, Month = {January}, ISSN = {1090-7165}, url = {http://dx.doi.org/10.1007/s10461-014-0746-7}, Abstract = {By 2015, one-half of all HIV-positive persons in the U.S. will be 50-plus years of age, and as many as 30 % of older adults living with HIV/AIDS continue to engage in unprotected sexual intercourse. Contemporary positive prevention models often include mental health treatment as a key component of HIV prevention interventions. This secondary data analysis characterized longitudinal patterns of sexual behavior in HIV-positive older adults enrolled in a randomized controlled trial of group mental health interventions and assessed the efficacy of psychosocial treatments that targeted depression to reduce sexual risk behavior. Participants were 295 HIV-positive adults ≥50 years of age experiencing mild to severe depressive symptoms, randomized to one of three study conditions: a 12-session coping improvement group intervention, a 12-session interpersonal support group intervention, or individual therapy upon request. Approximately one-fifth of participants reported one or more occasions of unprotected anal or vaginal intercourse with HIV-negative sexual partners or persons of unknown HIV serostatus over the study period. Changes in sexual behavior did not vary by intervention condition, indicating that standalone treatments that target and reduce depression may be insufficient to reduce sexual risk behavior in depressed HIV-positive older adults.}, Doi = {10.1007/s10461-014-0746-7}, Key = {fds253935} } @article{fds318786, Author = {Choi, KW and Watt, MH and Skinner, D and Kalichman, SC and Sikkema, KJ}, Title = {"Wine you get every day, but a child you can't replace": The perceived impact of parental drinking on child outcomes in a South African township.}, Journal = {Journal of Child and Adolescent Mental Health}, Volume = {27}, Number = {3}, Pages = {173-187}, Year = {2015}, Month = {January}, url = {http://dx.doi.org/10.2989/17280583.2015.1113974}, Abstract = {This study explored the perceived impact of parental drinking on children in a South African township where alcohol abuse is prevalent and high levels of existing poverty and violence may exacerbate potential consequences on children.Qualitative in-depth interviews were conducted with 92 male and female participants recruited from alcohol-serving venues in Cape Town, South Africa.Grounded theory analyses revealed three major aspects of parental drinking - intoxication, venue attendance and expenditures on alcohol - which participants linked to negative proximal outcomes (e.g., child neglect, abuse and exposure to alcohol culture) and long-term outcomes (e.g., fractured parent-child relationships and problematic youth behaviours). In addition, preliminary accounts from some participants suggested that parents may experience tensions between desires to reduce drinking for child-related reasons and complex factors maintaining their drinking behaviour, including the use of alcohol to cope with stressors and trauma.This study provides novel insights into the consequences and motivations of parental drinking in a high-risk context. Contextual risks (e.g., poverty and violence) that exacerbate the impact of parental drinking on children may be the same factors that continue to shape intergenerational alcohol use in this community. Findings highlight opportunities for further research and interventions to support child protection in South Africa.}, Doi = {10.2989/17280583.2015.1113974}, Key = {fds318786} } @article{fds318785, Author = {Pettifor, A and Corneli, A and Kamanga, G and McKenna, K and Rosenberg, NE and Yu, X and Ou, S-S and Massa, C and Wiyo, P and Lynn, D and Tharaldson, J and Golin, C and Hoffman, I and HPTN 062 Study Protocol Team}, Title = {HPTN 062: A Pilot Randomized Controlled Trial Exploring the Effect of a Motivational-Interviewing Intervention on Sexual Behavior among Individuals with Acute HIV Infection in Lilongwe, Malawi.}, Journal = {Plos One}, Volume = {10}, Number = {5}, Pages = {e0124452}, Year = {2015}, url = {http://dx.doi.org/10.1371/journal.pone.0124452}, Abstract = {OBJECTIVE: We pilot tested a Motivational Interviewing (MI) -based counseling intervention for individuals with Acute HIV Infection (AHI) to reduce risky sexual behavior in Lilongwe, Malawi. METHODS: Twenty-eight individuals diagnosed with AHI were randomized to receive either brief education alone, or the brief education plus the MI-based intervention, called Uphungu Wanga. Participants in Uphungu Wanga received four sessions delivered on the day of diagnosis, three days later and at weeks 1 and 2 with a booster session at week 8; participants were followed for 24 weeks from diagnosis. An interviewer administered quantitative questionnaire was conducted at baseline and at weeks 2, 4, 8, 12, 16, 20 and 24. Semi-structured qualitative interviews (SSI) were conducted at weeks 2, 8, 12, and 24. RESULTS: The majority of participants in both arms reported rapid and sustained behavior change following diagnosis with AHI. Very few participants reported having sex without a condom after diagnosis. Participants reported a trend towards fewer sex partners and abstaining from sex during study follow-up. Participants in the MI-based arm provided concrete examples of risk reduction strategies in the SSIs while those in the brief education arm primarily described reducing risk behavior, suggesting that the MI-based group may have acquired more risk reduction skills. CONCLUSIONS: Individuals in both study arms reduced risky sexual behaviors after diagnosis with AHI. We found few major differences between study arms during the 6-month follow up period in self-reported sexual behaviors therefore a MI-based intervention may not be needed to trigger behavior change following AHI. However, comparing the MI-based intervention to repeated brief education sessions made it difficult to assess the potential benefit of an MI-based intervention in a setting where standard counseling often consists of one post-test session. Nevertheless, provision of counseling immediately following diagnosis with HIV to support behavior change should remain a priority. TRIAL REGISTRATION: ClinicalTrials.gov NCT01197027.}, Doi = {10.1371/journal.pone.0124452}, Key = {fds318785} } @article{fds253884, Author = {Otwombe, KN and Dietrich, J and Sikkema, KJ and Coetzee, J and Hopkins, KL and Laher, F and Gray, GE}, Title = {Exposure to and experiences of violence among adolescents in lower socio-economic groups in Johannesburg, South Africa Health behavior, health promotion and society}, Journal = {Bmc Public Health}, Volume = {15}, Number = {1}, Year = {2015}, ISSN = {1471-2458}, url = {http://dx.doi.org/10.1186/s12889-015-1780-8}, Abstract = {© 2015 Otwombe et al.; licensee BioMed Central.Background: We explored exposure to and experiences of violence and their risk factors amongst ethnically diverse adolescents from lower socio economic groups in Johannesburg. Methods: This cross-sectional study recruited a stratified sample of 16-18 year old adolescents from four low socio-economic suburbs in Johannesburg to reflect ethnic group clustering. We collected socio-demographic, sexual behaviour, alcohol and drug use and trauma events data. Proportions and risk factors were assessed by chi-square and logistic regression. Results: Of 822 adolescents, 57% (n∈=∈469) were female. Approximately 62% (n∈=∈506) were Black, 13% (n∈=∈107) Coloured, 13% (n∈=∈106) Indian and 13% (n∈=∈103) White. Approximately 67% (n∈=∈552) witnessed violence to a non-family member, 28% (n∈=∈228) experienced violence by a non-family member, and 10% (n∈=∈83) reported sexual abuse. Multivariate analysis determined that witnessing violence in the community was associated with being Black (OR: 4.6, 95%CI: 2.7-7.9), Coloured (OR: 3.9, 95%CI: 2.0-7.4) or White (OR: 8.0, 95%CI:4.0-16.2), repeating a grade (OR: 1.5, 95%CI: 1.01-2.1), having more than one sexual partner (OR: 1.7, 95%CI: 1.1-2.5) and ever taking alcohol (OR: 2.1, 95%CI: 1.5-2.9). Witnessing violence in the family was associated with being female (OR: 1.8, 95%CI: 1.3-2.6), being Black (OR: 2.2, 95%CI: 1.1-4.1), or White (OR: 3.0, 95%CI: 1.4-6.4), repeating a grade (OR: 1.6, 95%CI: 1.1-2.2) and ever taking alcohol (OR: 2.9, 95%CI: 2.0-4.3). Conclusions: In low socio-economic areas in Johannesburg, Black, White and Coloured adolescents experience a high burden of violence. Interventions to mitigate the effects of violence are urgently required.}, Doi = {10.1186/s12889-015-1780-8}, Key = {fds253884} } @article{fds253930, Author = {Choi, KW and Somers, TJ and Babyak, MA and Sikkema, KJ and Blumenthal, JA and Keefe, FJ}, Title = {The relationship between pain and eating among overweight and obese individuals with osteoarthritis: an ecological momentary study.}, Journal = {Pain Res Manag}, Volume = {19}, Number = {6}, Pages = {e159-e163}, Year = {2014}, Month = {November}, ISSN = {1203-6765}, url = {http://dx.doi.org/10.1155/2014/598382}, Abstract = {BACKGROUND: Osteoarthritis (OA) patients who are overweight or obese report higher levels of pain compared with their normal-weight OA counterparts. Evidence suggests that overweight or obese OA patients also experience pain relief from eating foods high in calories, fat or sugar. Eating to alleviate pain may be problematic because it can lead to additional weight gain, which may contribute to heightened pain. OBJECTIVES: To investigate the relationship between pain and food intake using ecological momentary assessments in a sample of 71 overweight and obese OA patients. METHODS: Participants completed two consecutive days of diary entries in which they recorded their levels of pain, mood and food intake throughout the day. Data were analyzed using generalized estimating equations that modelled pain as a predictor of calorie, fat and sugar intake. All models were adjusted for sex, body mass index, negative mood, time and treatment history. RESULTS: Pain significantly predicted calorie (Z=2.57; P=0.01) and fat intake (Z=1.99; P=0.05). CONCLUSIONS: Using ecological momentary assessments as a novel approach, the present study provides preliminary data supporting a relationship between pain and food intake among overweight and obese OA patients. Continued advances in our understanding of the relationship between pain and eating behaviour may help to optimize intervention strategies for these patients.}, Doi = {10.1155/2014/598382}, Key = {fds253930} } @article{fds253905, Author = {Corneli, A and Pettifor, A and Kamanga, G and Golin, C and McKenna, K and Ou, S-S and Hamela, G and Massa, C and Martinson, F and Tharaldson, J and Hilgenberg, D and Yu, X and Chege, W and Hoffman, I and HPTN 062 study team}, Title = {HPTN 062: a feasibility and acceptability pilot intervention to reduce HIV transmission risk behaviors among individuals with acute and early HIV infection in Lilongwe, Malawi.}, Journal = {Aids Behav}, Volume = {18}, Number = {9}, Pages = {1785-1800}, Year = {2014}, Month = {September}, ISSN = {1090-7165}, url = {http://dx.doi.org/10.1007/s10461-014-0707-1}, Abstract = {Acute HIV infection (AHI) is a relatively brief period of time when individuals are highly infectious and the opportunity to intervene to prevent forward transmission is extremely limited. HPTN 062 partnered with CHAVI 001 to evaluate the feasibility and acceptability of a motivational interviewing (MI)-based counseling intervention to reduce HIV-transmission risk behaviors among individuals with acute and early HIV infection in Lilongwe, Malawi. Participants were randomized to receive either (1) brief education sessions about HIV and AHI; or (2) the same brief education sessions plus an MI-based counseling intervention called Uphungu Wanga. Although Uphungu Wanga was determined to be feasible and acceptable, few major differences existed between the two arms with regard to acceptability, feasibility, and self-reported sexual behaviors. We therefore conclude that an additional MI-based counseling intervention may not be needed during the short period of AHI. Instead, we recommend that individuals with AHI receive frequent, but brief, counseling immediately after diagnosis and then transition to receiving counseling at less frequent intervals until they can initiate antiretroviral therapy. Other recommendations are provided.}, Doi = {10.1007/s10461-014-0707-1}, Key = {fds253905} } @article{fds253929, Author = {Watt, MH and Eaton, LA and Choi, KW and Velloza, J and Kalichman, SC and Skinner, D and Sikkema, KJ}, Title = {"It's better for me to drink, at least the stress is going away": perspectives on alcohol use during pregnancy among South African women attending drinking establishments.}, Journal = {Social Science & Medicine}, Volume = {116}, Pages = {119-125}, Year = {2014}, Month = {September}, ISSN = {0277-9536}, url = {http://dx.doi.org/10.1016/j.socscimed.2014.06.048}, Abstract = {The Western Cape of South Africa has one of the highest rates of fetal alcohol spectrum disorders (FASD) globally. Reducing alcohol use during pregnancy is a pressing public health priority for this region, but insight into the experiences of women who drink during pregnancy is lacking. Convenience sampling in alcohol-serving venues was used to identify women who were currently pregnant (n = 12) or recently post-partum (n = 12) and reported drinking during the pregnancy period. In-depth qualitative interviews were conducted between April and August 2013. Interviews explored drinking narratives, with textual data analyzed for themes related to factors that contributed to drinking during pregnancy. All but one woman reported her pregnancy as unplanned. The majority sustained or increased drinking after pregnancy recognition, with patterns typically including multiple days of binge drinking per week. Analysis of the textual data revealed five primary factors that contributed to drinking during pregnancy: 1) women used alcohol as a strategy to cope with stressors and negative emotions, including those associated with pregnancy; 2) women drank as a way to retain social connection, often during a difficult period of life transition; 3) social norms in women's peer groups supported drinking during pregnancy; 4) women lacked attachment to the pregnancy or were resistant to motherhood; and 5) women were driven physiologically by alcohol addiction. Our data suggest that alcohol-serving settings are important sites to identify and target women at risk of drinking during pregnancy. Intervention approaches to reduce alcohol use during pregnancy should include counseling and contraception to prevent unwanted pregnancies, mental health and coping interventions targeting pregnant women, peer-based interventions to change norms around perinatal drinking, and treatment for alcohol dependence during pregnancy. Our findings suggest that innovative interventions that go beyond the boundaries of the health care system are urgently needed to address FASD in this region.}, Doi = {10.1016/j.socscimed.2014.06.048}, Key = {fds253929} } @article{fds253934, Author = {Sikkema, KJ and Abler, L and Hansen, NB and Wilson, PA and Drabkin, AS and Kochman, A and MacFarlane, JC and DeLorenzo, A and Mayer, G and Watt, MH and Nazareth, W}, Title = {Positive choices: outcomes of a brief risk reduction intervention for newly HIV-diagnosed men who have sex with men.}, Journal = {Aids and Behavior}, Volume = {18}, Number = {9}, Pages = {1808-1819}, Year = {2014}, Month = {September}, ISSN = {1090-7165}, url = {http://dx.doi.org/10.1007/s10461-014-0782-3}, Abstract = {Positive choices (PC), a brief sexual risk reduction intervention conducted with newly HIV-diagnosed men who have sex with men (MSM), was evaluated for preliminary efficacy. Participants were enrolled if they reported unprotected anal intercourse (UAI) in the three months prior to HIV diagnosis (n = 102). Three months after diagnosis, participants completed baseline assessments and were randomly assigned to receive the 3-session PC intervention or the comprehensive standard of care (C-SoC) at a community health center. Participants completed assessments at 3- (post intervention), 6-, and 9- months after baseline. Compared to C-SoC participants, PC participants significantly reduced the frequency of UAI with HIV serodiscordant (HIV negative or status unknown) partners over the 9-month follow-up period. No differences by condition were found in the frequency of UAI with all partners. The findings from this trial suggest that brief risk reduction approaches for newly-diagnosed MSM integrated into HIV care can benefit secondary HIV prevention efforts.}, Doi = {10.1007/s10461-014-0782-3}, Key = {fds253934} } @article{fds253926, Author = {Abler, LA and Sikkema, KJ and Watt, MH and Eaton, LA and Choi, KW and Kalichman, SC and Skinner, D and Pieterse, D}, Title = {Longitudinal cohort study of depression, post-traumatic stress, and alcohol use in South African women who attend alcohol serving venues.}, Journal = {Bmc Psychiatry}, Volume = {14}, Pages = {224}, Year = {2014}, Month = {August}, url = {http://dx.doi.org/10.1186/s12888-014-0224-9}, Abstract = {In South Africa, alcohol use poses a public health burden. Hazardous alcohol use often co-occurs with psychological distress (e.g., depression and post-traumatic stress). However, the majority of the research establishing the relationship between alcohol use and psychological distress has been cross-sectional, so the nature of co-occurring changes in psychological distress and alcohol use over time is not well characterized. The objective of this study is to examine the longitudinal relationship between psychological distress and alcohol use among South African women who attend alcohol serving venues.Four waves of data were collected over the course of a year from 560 women in a Cape Town township who attended drinking venues. At each assessment wave, participants reported depressive symptoms, post-traumatic stress symptoms, and alcohol use. Multilevel growth models were used to: 1) assess the patterns of alcohol use; 2) examine how depressive symptoms uniquely, post-traumatic stress symptoms uniquely, and depressive and post-traumatic stress symptoms together were associated with alcohol use; and 3) characterize the within person and between person associations of depressive symptoms and post-traumatic stress symptoms with alcohol use.Women reported high levels of alcohol use throughout the study period, which declined slightly over time. Post-traumatic stress symptoms were highly correlated with depressive symptoms. Modeled separately, both within person and between person depressive and post-traumatic stress symptoms were uniquely associated with alcohol use. When modeled together, significant between person effects indicated that women who typically have more post-traumatic stress symptoms, when controlling for depressive symptoms, are at risk for increased alcohol use; however, women with more depressive symptoms, controlling for post-traumatic stress symptoms, do not have differential risk for alcohol use. Significant within person effects indicated an interaction between depressive and post-traumatic stress symptoms; women reported more alcohol use than usual at times when they had higher post-traumatic stress symptoms, and this increase in alcohol use was further exacerbated for women who also had higher depressive symptoms than usual.These findings suggest that interventions targeting post-traumatic stress, especially when post-traumatic stress is comorbid with depression, may reduce alcohol use among South African women who drink.}, Doi = {10.1186/s12888-014-0224-9}, Key = {fds253926} } @article{fds253928, Author = {Eloff, I and Finestone, M and Makin, JD and Boeving-Allen, A and Visser, M and Ebersöhn, L and Ferreira, R and Sikkema, KJ and Briggs-Gowan, MJ and Forsyth, BWC}, Title = {A randomized clinical trial of an intervention to promote resilience in young children of HIV-positive mothers in South Africa.}, Journal = {Aids}, Volume = {28 Suppl 3}, Pages = {S347-S357}, Year = {2014}, Month = {July}, ISSN = {0269-9370}, url = {http://dx.doi.org/10.1097/qad.0000000000000335}, Keywords = {Alcohol • Fetal alcohol syndrome • Pregnancy • South Africa}, Abstract = {The objective of this study is to assess the efficacy of an intervention designed to promote resilience in young children living with their HIV-positive mothers.HIV-positive women attending clinics in Tshwane, South Africa, and their children, aged 6-10 years, were randomized to the intervention (I) or standard care (S). The intervention consisted of 24 weekly group sessions led by community care workers. Mothers and children were in separate groups for 14 sessions, followed by 10 interactive sessions. The primary focus was on parent-child communication and parenting. Assessments were completed by mothers and children at baseline and 6, 12 and 18 months. Repeated mixed linear analyses were used to assess change over time.Of 390 mother-child pairs, 84.6% (I: 161 and S: 169) completed at least two interviews and were included in the analyses. Children's mean age was 8.4 years and 42% of mothers had been ill in the prior 3 months. Attendance in groups was variable: only 45.7% attended more than 16 sessions. Intervention mothers reported significant improvements in children's externalizing behaviours (ß = -2.8, P = 0.002), communication (ß = 4.3, P = 0.025) and daily living skills (ß = 5.9, P = 0.024), although improvement in internalizing behaviours and socialization was not significant (P = 0.061 and 0.052, respectively). Intervention children reported a temporary increase in anxiety but did not report differences in depression or emotional intelligence.This is the first study demonstrating benefits of an intervention designed to promote resilience among young children of HIV-positive mothers. The intervention was specifically designed for an African context and has the potential to benefit large numbers of children, if it can be widely implemented.}, Language = {eng}, Doi = {10.1097/qad.0000000000000335}, Key = {fds253928} } @article{fds253932, Author = {Thurston, IB and Dietrich, J and Bogart, LM and Otwombe, KN and Sikkema, KJ and Nkala, B and Gray, GE}, Title = {Correlates of sexual risk among sexual minority and heterosexual South African youths.}, Journal = {American Journal of Public Health}, Volume = {104}, Number = {7}, Pages = {1265-1269}, Year = {2014}, Month = {July}, ISSN = {0090-0036}, url = {http://dx.doi.org/10.2105/ajph.2013.301865}, Keywords = {adult victims • alcohol and drugs • cultural contexts • domestic violence • predicting domestic violence • sexual assault}, Abstract = {We explored psychosocial correlates of sexual risk among heterosexual and sexual minority youths (SMYs) in Johannesburg, South Africa. Young people 16 to 18 years old (n = 822) were administered surveys assessing demographic characteristics, sexual behaviors, mental health, and parent-child communication. Adjusted multivariate regressions examining correlates of sexual risk revealed that SMYs had more sexual partners than heterosexual youths (B = 3.90; SE = 0.95; P < .001) and were more likely to engage in sex trading (OR = 3.11; CI = 1.12-8.62; P < .05). South African SMYs are at increased risk relative to their heterosexual peers.}, Language = {eng}, Doi = {10.2105/ajph.2013.301865}, Key = {fds253932} } @article{fds253950, Author = {Eaton, LA and Kalichman, SC and Pitpitan, EV and Cain, DN and Watt, MH and Sikkema, KJ and Skinner, D and Pieterse, D}, Title = {The relationship between attending alcohol serving venues nearby versus distant to one's residence and sexual risk taking in a South African township.}, Journal = {Journal of Behavioral Medicine}, Volume = {37}, Number = {3}, Pages = {381-390}, Year = {2014}, Month = {June}, ISSN = {1573-3521}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23404137}, Keywords = {Adult • Alcohol Drinking • Data Collection • Epidemics • Female • HIV Infections • Homosexuality, Male • Humans • Male • Medically Underserved Area • Risk-Taking • Sex Offenses • Sexual Behavior • Sexual Partners • South Africa • Substance-Related Disorders • epidemiology • epidemiology* • statistics & numerical data • statistics & numerical data* • transmission}, Abstract = {South Africa remains a country with one of the highest prevalence rates of HIV/AIDS at 18% among 15-49 year olds. Underdeveloped urban areas, or townships, are particularly hard hit by the HIV/AIDS epidemic. Alcohol use in these townships has been established as an important risk factor for HIV transmission. Likewise, alcohol serving venues (shebeens) have been identified as sites where substance abuse and sexual risk taking occur. However, little is known about how proximity of alcohol serving establishments (shebeens) to one's residence may be related to sexual risk-taking We surveyed 3,261 men and women attending shebeens in a township located in Cape Town, South Africa. We investigated the relationships between attending nearby (<15 min walk) versus distant (>15 min walk) shebeens, and sex and substance abuse related risk-taking. Women who attended distant shebeens versus nearby shebeens relative to their residence were approximately twice as likely to report HIV positive status. Bivariate analyses demonstrated that these women were also more likely to report other sexually transmitted infections, greater numbers of sex partners, higher rates of alcohol and drug use, and seeking out new sex partners at shebeen. No differences in sex behavior, substance use or HIV/STI were identified among men. Proximity of shebeens appears to be an important contextual factor in explaining HIV/STI transmission risk-taking. Future studies should focus on how anonymity may be related to sexual risk and substance use behaviors among women in South African townships.}, Language = {eng}, Doi = {10.1007/s10865-013-9495-8}, Key = {fds253950} } @article{fds253952, Author = {Pitpitan, EV and Kalichman, SC and Eaton, LA and Watt, MH and Sikkema, KJ and Skinner, D and Pieterse, D and Cain, D}, Title = {Men (and women) as "sellers" of sex in alcohol-serving venues in Cape Town, South Africa.}, Journal = {Prevention Science : the Official Journal of the Society for Prevention Research}, Volume = {15}, Number = {3}, Pages = {296-308}, Year = {2014}, Month = {June}, ISSN = {1573-6695}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23494405}, Keywords = {Adult • Alcohol Drinking • Data Collection • Epidemics • Female • HIV Infections • Homosexuality, Male • Humans • Male • Medically Underserved Area • Risk-Taking • Sex Offenses • Sexual Behavior • Sexual Partners • South Africa • Substance-Related Disorders • epidemiology • epidemiology* • statistics & numerical data • statistics & numerical data* • transmission}, Abstract = {The relationship between transactional sex, HIV risk, and partner violence has been well documented in South Africa, but research has focused primarily on women and has not been conducted in high-risk social contexts. The aim of this study was to examine associations between transactional sex and HIV risk among women and men in alcohol-serving venues in Cape Town, South Africa. We surveyed 1,989 women and 2,468 men attending alcohol-serving venues in Cape Town, South Africa to assess transactional sex behavior (i.e., receiving money or goods in exchange for sex), alcohol and drug use, history of childhood abuse, current relationship violence, and sexual risk behaviors. Among both women and men, trading sex was related to higher alcohol use, greater likelihood of drug use, substance use in sexual contexts, and a greater likelihood of experiencing physical and sexual violence. Compared to other women, women who traded sex reported a greater proportion of condom-unprotected sex; this relationship was not found for men. Analyses showed that men were almost twice as more likely to report trading sex for items, including money or alcohol, than women (9.7 vs. 5.8 %). Overall, men who traded sex were similar to their female counterparts. Similar associations between trading sex and different risk behaviors were found among women and men with limited economic means and substance use problems. Future research should more closely study transactional sex in high-risk venues as it relates to violence and should examine men who trade sex as a potential bridge population between heterosexual women and men who have sex with men.}, Language = {eng}, Doi = {10.1007/s11121-013-0381-y}, Key = {fds253952} } @article{fds253954, Author = {Eaton, LA and Pitpitan, EV and Kalichman, SC and Sikkema, KJ and Skinner, D and Watt, MH and Pieterse, D and Cain, DN}, Title = {Food insecurity and alcohol use among pregnant women at alcohol-serving establishments in South Africa.}, Journal = {Prevention Science : the Official Journal of the Society for Prevention Research}, Volume = {15}, Number = {3}, Pages = {309-317}, Year = {2014}, Month = {June}, ISSN = {1573-6695}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23526080}, Keywords = {Advisory Committees* • Community Networks • Community-Based Participatory Research • Community-Institutional Relations* • Cooperative Behavior • Decision Making • Family • HIV Infections • Health Promotion • Health Resources • Humans • Kenya • Mental Health* • Power (Psychology) • Preventive Health Services • Residence Characteristics • Role • Rural Population • ethics* • prevention & control*}, Abstract = {South Africa has the highest rate of fetal alcohol syndrome (FAS) in the world. While efforts have been made to curb the high rate of FAS, little is known about situational factors that may contribute to alcohol use during pregnancy. In the current paper, we focus on the role of food insecurity and its relationship to alcohol use among pregnant women. Women completed computer-assisted interviews. Generalized linear modeling was used in all analyses. Women attending alcohol-serving establishments in a township in Cape Town, South Africa were recruited for the study. Five hundred sixty women were sampled and 95 women reported being pregnant. High levels of alcohol use were reported among pregnant women: 65 % of women consumed alcohol at least every month and 29 % consumed alcohol as often as two to three times per week. Thirty-four percent of the women reported having six or more drinks per occasion on at least a weekly basis. The majority (87 %) of pregnant women reported experiencing some form of food insecurity (e.g., food unavailable, eating less) in the past month. Alcohol use was significantly associated with food insecurity, even when controlling for relevant demographic variables. Intervention with pregnant women who consume alcohol is urgently needed. Future research should focus on understanding the intersection of food insecurity and alcohol, and how the experience of food insecurity may contribute to greater rates of alcohol use and abuse among pregnant women.}, Language = {eng}, Doi = {10.1007/s11121-013-0386-6}, Key = {fds253954} } @article{fds253936, Author = {Coetzee, J and Dietrich, J and Otwombe, K and Nkala, B and Khunwane, M and van der Watt, M and Sikkema, KJ and Gray, GE}, Title = {Predictors of parent-adolescent communication in post-apartheid South Africa: a protective factor in adolescent sexual and reproductive health.}, Journal = {Journal of Adolescence}, Volume = {37}, Number = {3}, Pages = {313-324}, Year = {2014}, Month = {April}, ISSN = {0140-1971}, url = {http://dx.doi.org/10.1016/j.adolescence.2014.01.006}, Keywords = {Adolescence • Ethnicity • Parent–adolescent communication • Post-apartheid South Africa • Survey}, Abstract = {In the HIV context, risky sexual behaviours can be reduced through effective parent-adolescent communication. This study used the Parent Adolescent Communication Scale to determine parent-adolescent communication by ethnicity and identify predictors of high parent-adolescent communication amongst South African adolescents post-apartheid. A cross-sectional interviewer-administered survey was administered to 822 adolescents from Johannesburg, South Africa. Backward stepwise multivariate regressions were performed. The sample was predominantly Black African (62%, n = 506) and female (57%, n = 469). Of the participants, 57% (n = 471) reported high parent-adolescent communication. Multivariate regression showed that gender was a significant predictor of high parent-adolescent communication (Black African OR:1.47, CI: 1.0-2.17, Indian OR: 2.67, CI: 1.05-6.77, White OR: 2.96, CI: 1.21-7.18). Female-headed households were predictors of high parent-adolescent communication amongst Black Africans (OR:1.49, CI: 1.01-2.20), but of low parent-adolescent communication amongst Whites (OR:0.36, CI: 0.15-0.89). Overall levels of parent-adolescent communication in South Africa are low. HIV prevention programmes for South African adolescents should include information and skills regarding effective parent-adolescent communication.}, Language = {eng}, Doi = {10.1016/j.adolescence.2014.01.006}, Key = {fds253936} } @article{fds253938, Author = {Choi, KW and Abler, LA and Watt, MH and Eaton, LA and Kalichman, SC and Skinner, D and Pieterse, D and Sikkema, KJ}, Title = {Drinking before and after pregnancy recognition among South African women: the moderating role of traumatic experiences.}, Journal = {Bmc Pregnancy and Childbirth}, Volume = {14}, Number = {3}, Pages = {97}, Year = {2014}, Month = {March}, ISSN = {1471-2393}, url = {http://dx.doi.org/10.1186/1471-2393-14-97}, Keywords = {Adolescence • Ethnicity • Parent–adolescent communication • Post-apartheid South Africa • Survey}, Abstract = {South Africa has one of the world's highest rates of fetal alcohol spectrum disorder (FASD) and interpersonal trauma. These co-occurring public health problems raise the need to understand alcohol consumption among trauma-exposed pregnant women in this setting. Since a known predictor of drinking during pregnancy is drinking behavior before pregnancy, this study explored the relationship between women's drinking levels before and after pregnancy recognition, and whether traumatic experiences - childhood abuse or recent intimate partner violence (IPV) - moderated this relationship.Women with incident pregnancies (N = 66) were identified from a longitudinal cohort of 560 female drinkers in a township of Cape Town, South Africa. Participants were included if they reported no pregnancy at one assessment and then reported pregnancy four months later at the next assessment. Alcohol use was measured by the Alcohol Use Disorders Identification Test (AUDIT), and traumatic experiences of childhood abuse and recent IPV were also assessed. Hierarchical linear regressions controlling for race and age examined childhood abuse and recent IPV as moderators of the effect of pre-pregnancy recognition drinking on post-pregnancy recognition AUDIT scores.Following pregnancy recognition, 73% of women reported drinking at hazardous levels (AUDIT ≥ 8). Sixty-four percent reported early and/or recent exposure to trauma. While drinking levels before pregnancy significantly predicted drinking levels after pregnancy recognition, t(64) = 3.50, p < .01, this relationship was moderated by experiences of childhood abuse, B = -.577, t(60) = -2.58, p = .01, and recent IPV, B = -.477, t(60) = -2.16, p = .04. Pregnant women without traumatic experiences reported drinking at levels consistent with levels before pregnancy recognition. However, women with traumatic experiences tended to report elevated AUDIT scores following pregnancy recognition, even if low-risk drinkers previously.This study explored how female drinkers in South Africa may differentially modulate their drinking patterns upon pregnancy recognition, depending on trauma history. Our results suggest that women with traumatic experiences are more likely to exhibit risky alcohol consumption when they become pregnant, regardless of prior risk. These findings illuminate the relevance of trauma-informed efforts to reduce FASD in South Africa.}, Language = {eng}, Doi = {10.1186/1471-2393-14-97}, Key = {fds253938} } @article{fds253931, Author = {Allen, AB and Finestone, M and Eloff, I and Sipsma, H and Makin, J and Triplett, K and Ebersöhn, L and Sikkema, K and Briggs-Gowan, M and Visser, M and Ferreira, R and Forsyth, BWC}, Title = {The role of parenting in affecting the behavior and adaptive functioning of young children of HIV-infected mothers in South Africa.}, Journal = {Aids and Behavior}, Volume = {18}, Number = {3}, Pages = {605-616}, Year = {2014}, Month = {March}, ISSN = {1090-7165}, url = {http://dx.doi.org/10.1007/s10461-013-0544-7}, Abstract = {Prior investigations suggest that maternal HIV/AIDS poses significant challenges to young children. This study investigates the relationships between mothers' psychological functioning, parenting, and children's behavioral outcomes and functioning in a population of women living with HIV (N = 361) with a child between the ages of 6 and 10 years in Tshwane, South Africa. Utilizing path analysis, findings revealed that maternal depression is related to increased parenting stress and parent-child dysfunction, maternal coping is related to parenting style, and maternal coping, parenting style and stress, and parent-child dysfunction are associated with children's behavior and functioning, with parenting emerging as an important mediator. These findings suggest that interventions for women living with HIV and their children should not only address maternal psychological functioning (depression and coping), but should also focus on parenting, promoting a positive approach.}, Doi = {10.1007/s10461-013-0544-7}, Key = {fds253931} } @article{fds253937, Author = {Eaton, LA and Pitpitan, EV and Kalichman, SC and Sikkema, KJ and Skinner, D and Watt, MH and Pieterse, D and Cain, DN}, Title = {Beliefs about fetal alcohol spectrum disorder among men and women at alcohol serving establishments in South Africa.}, Journal = {The American Journal of Drug and Alcohol Abuse}, Volume = {40}, Number = {2}, Pages = {87-94}, Year = {2014}, Month = {March}, ISSN = {0095-2990}, url = {http://dx.doi.org/10.3109/00952990.2013.830621}, Keywords = {Adolescence • Ethnicity • Parent–adolescent communication • Post-apartheid South Africa • Survey}, Abstract = {South Africa has one of the highest rates of fetal alcohol spectrum disorder (FASD) in the world. However, little is known about what men and women who attend alcohol serving establishments believe about alcohol use during pregnancy and how these beliefs may be related to alcohol use.To understand FASD beliefs and related behaviors among men and women attending alcohol-serving establishments.We surveyed 1047 men (n = 565) and women (n = 482) -including pregnant women and men with pregnant partners- attending alcohol serving establishments in a township located in Cape Town, South Africa.Among both pregnant (n = 53) and non-pregnant (n = 429) women, 54% reported drinking alcohol at least 2-4 times per month, and 57% reported having at least 3-4 alcohol drinks during a typical drinking session. Pregnant women were less likely to believe that they should not drink alcohol and that alcohol can harm a fetus when compared to non-pregnant women. Similar findings were observed between men with pregnant partners compared to men without pregnant partners. Among women, beliefs about how much alcohol pregnant women can safely drink were associated with self-reported alcohol use.Efforts to address FASD need to focus on understanding how men and women perceive alcohol use during pregnancy and situational factors that contribute to alcohol consumption among pregnant women attending alcohol serving establishments. Structural and individual-level interventions targeting women at alcohol serving establishments should be prioritized to mitigate alcohol use during pregnancy.}, Language = {eng}, Doi = {10.3109/00952990.2013.830621}, Key = {fds253937} } @article{fds253941, Author = {Watt, MH and Meade, CS and Kimani, S and MacFarlane, JC and Choi, KW and Skinner, D and Pieterse, D and Kalichman, SC and Sikkema, KJ}, Title = {The impact of methamphetamine ("tik") on a peri-urban community in Cape Town, South Africa.}, Journal = {Int J Drug Policy}, Volume = {25}, Number = {2}, Pages = {219-225}, Year = {2014}, Month = {March}, ISSN = {1873-4758}, url = {http://www.ncbi.nlm.nih.gov/pubmed/24246503}, Keywords = {Methamphetamine • Qualitative • South Africa}, Abstract = {BACKGROUND: Over the last decade, South Africa's Western Cape has experienced a dramatic increase in methamphetamine ("tik") use. Our study explored local impressions of the impact of tik use in a peri-urban township community in Cape Town, South Africa. METHODS: We conducted individual in-depth interviews with 55 women and 37 men who were regular attendees of alcohol-serving venues. Interviews were recorded and transcribed. A content analysis approach was used to identify themes related to the impact of tik use based on levels of the socio-ecological framework (individual, inter-personal and community). RESULTS: Tik use was reported to be a greater issue among Coloureds, compared to Blacks. At an individual level, respondents reported that tik use had adverse effects on mental, physical, and economic well-being, and limited future opportunities through school drop-out and incarceration. At an inter-personal level, respondents reported that tik use contributed to physical and sexual violence as well as increased rates of sexual risk behaviour, particularly through transactional sex relationships. Respondents described how tik use led to household conflict, and had negative impacts on children, including neglect and poor birth outcomes. At a community level, respondents linked tik use to increased rates of crime, violence and corruption, which undercut community cohesion. CONCLUSIONS: Our results highlight the negative impact that tik is having on individuals, households and the overall community in a peri-urban setting in South Africa. There is a clear need for interventions to prevent tik use in South Africa and to mitigate and address the impact of tik on multiple levels.}, Language = {eng}, Doi = {10.1016/j.drugpo.2013.10.007}, Key = {fds253941} } @article{fds253890, Author = {Miles, MS and Holditch-Davis, D and Pedersen, C and J.Eron, J and Schwartz, T}, Title = {Emotional distress in african american women with hiv}, Pages = {35-50}, Booktitle = {HIV: Issues with Mental Health and Illness}, Publisher = {Routledge}, Year = {2014}, Month = {January}, ISBN = {9781315785509}, url = {http://dx.doi.org/10.4324/9781315785509}, Doi = {10.4324/9781315785509}, Key = {fds253890} } @article{fds253945, Author = {Choi, KW and Watt, MH and MacFarlane, JC and Sikkema, KJ and Skinner, D and Pieterse, D and Kalichman, SC}, Title = {Drinking in the Context of Life Stressors: A Multidimensional Coping Strategy Among South African Women.}, Journal = {Substance Use & Misuse}, Volume = {49}, Number = {1-2}, Pages = {66-76}, Year = {2014}, Month = {January}, ISSN = {1532-2491}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23905586}, Keywords = {Adult • Buprenorphine • Feasibility Studies • Female • HIV Infections* • Humans • Male • Naloxone • Narcotic Antagonists • Opiate Substitution Treatment • Opioid-Related Disorders • Patient Education as Topic • Risk Reduction Behavior • Sex Counseling • Sexual Behavior • Treatment Outcome • diagnosis • drug therapy • methods • methods* • prevention & control • psychology • therapeutic use • therapeutic use*}, Abstract = {This study explored narratives of drinking as a coping strategy among female drinkers in a South African township. In 2010-2011, we conducted qualitative in-depth interviews with 54 women recruited from 12 alcohol-serving venues. Most women drank heavily and linked their drinking to stressors. They were motivated to use drinking to manage their emotions, facilitate social engagement, and achieve a sense of empowerment, even while recognizing the limitations of this strategy. This study helps to contextualize heavy drinking behavior among women in this setting. Multifaceted interventions that help female drinkers to more effectively manage stressors may aid in reducing hazardous drinking.}, Language = {ENG}, Doi = {10.3109/10826084.2013.819365}, Key = {fds253945} } @article{fds253883, Author = {Sikkema, KJ and Meade, CS and Doughty-Berry, JD and Zimmerman, SO and Kloos, B and Snow, DL}, Title = {Community-level hiv prevention for persons with severe mental illness living in supportive housing programs: A pilot intervention study}, Journal = {Hiv: Issues With Mental Health and Illness}, Pages = {121-136}, Year = {2014}, url = {http://dx.doi.org/10.4324/9781315785509}, Doi = {10.4324/9781315785509}, Key = {fds253883} } @article{fds253891, Author = {Sikkema, KJ and Stein, DJ and Joska, J}, Title = {Traumatic stressors and the psychoneuroimmunology of HIV/AIDS}, Booktitle = {HIV/AIDS and Psychiatry}, Publisher = {WILEY}, Editor = {Joska, J and Stein, D and Grant, I}, Year = {2014}, Key = {fds253891} } @article{fds253933, Author = {Watt, MH and Wilson, SM and Joseph, M and Masenga, G and MacFarlane, JC and Oneko, O and Sikkema, KJ}, Title = {Religious coping among women with obstetric fistula in Tanzania.}, Journal = {Glob Public Health}, Volume = {9}, Number = {5}, Pages = {516-527}, Year = {2014}, ISSN = {1744-1692}, url = {http://dx.doi.org/10.1080/17441692.2014.903988}, Keywords = {Tanzania • gender • maternal health • obstetric fistula • religion}, Abstract = {Religion is an important aspect of Tanzanian culture, and is often used to cope with adversity and distress. This study aimed to examine religious coping among women with obstetric fistulae. Fifty-four women receiving fistula repair at a Tanzanian hospital completed a structured survey. The Brief RCOPE assessed positive and negative religious coping strategies. Analyses included associations between negative religious coping and key variables (demographics, religiosity, depression, social support and stigma). Forty-five women also completed individual in-depth interviews where religion was discussed. Although participants utilised positive religious coping strategies more frequently than negative strategies (p < .001), 76% reported at least one form of negative religious coping. In univariate analysis, negative religious coping was associated with stigma, depression and low social support. In multivariate analysis, only depression remained significant, explaining 42% of the variance in coping. Qualitative data confirmed reliance upon religion to deal with fistula-related distress, and suggested that negative forms of religious coping may be an expression of depressive symptoms. Results suggest that negative religious coping could reflect cognitive distortions and negative emotionality, characteristic of depression. Religious leaders should be engaged to recognise signs of depression and provide appropriate pastoral/spiritual counselling and general psychosocial support for this population.}, Language = {eng}, Doi = {10.1080/17441692.2014.903988}, Key = {fds253933} } @article{fds253940, Author = {Wilson, SM and Sikkema, KJ and Ranby, KW}, Title = {Gender moderates the influence of psychosocial factors and drug use on HAART adherence in the context of HIV and childhood sexual abuse.}, Journal = {Aids Care}, Volume = {26}, Number = {8}, Pages = {959-967}, Year = {2014}, ISSN = {1360-0451}, url = {http://www.ncbi.nlm.nih.gov/pubmed/24410324}, Keywords = {HIV • childhood sexual abuse • drug abuse • gender difference • medication adherence • structural equation modeling}, Abstract = {This study aimed to examine gender moderation within a stress and coping model of HIV medication adherence in adults with a history of childhood sexual abuse (CSA). Sequelae of CSA, including negative coping, psychological distress, and drug use, interfere with adherence to highly active antiretroviral treatment (HAART). These obstacles to adherence are likely moderated by gender. Gender may particularly influence the mediational effect of drug use on adherence. Participants included 206 adults living with HIV/AIDS and CSA. Categorical/continuous variable methodology in a structural equation modeling framework was used to test a multigroup model with women and men. Gender significantly moderated several effects in the model. For women, the effect of psychological distress on HAART adherence was mediated by drug use and the effect of drug use on viral load was mediated by HAART adherence. Among men, drug use did not significantly impact adherence. Since gender appears to moderate the effect of drug use on medication adherence, it is particularly important to address drug use within the context of HIV disease management in women with a history of CSA. Further, interventions to increase HAART adherence should take trauma history, gender, and drug abuse into account when assessing efficacy.}, Language = {eng}, Doi = {10.1080/09540121.2013.873765}, Key = {fds253940} } @article{fds253951, Author = {Skalski, LM and Sikkema, KJ and Heckman, TG and Meade, CS}, Title = {Coping styles and illicit drug use in older adults with HIV/AIDS.}, Journal = {Psychol Addict Behav}, Volume = {27}, Number = {4}, Pages = {1050-1058}, Year = {2013}, Month = {December}, ISSN = {1939-1501}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23438250}, Keywords = {Adult • Alcohol Drinking • Data Collection • Epidemics • Female • HIV Infections • Homosexuality, Male • Humans • Male • Medically Underserved Area • Risk-Taking • Sex Offenses • Sexual Behavior • Sexual Partners • South Africa • Substance-Related Disorders • epidemiology • epidemiology* • statistics & numerical data • statistics & numerical data* • transmission}, Abstract = {The prevalence of HIV infection in older adults is increasing; by 2015, over half of adults living with HIV/AIDS in the United States will be over 50. This study describes the prevalence of drug use and examines psychosocial predictors of drug use in a sample of HIV-infected adults aged 50 and older. Participants were 301 HIV-positive older adults enrolled in a clinical trial of a coping intervention aimed to reduce their depressive symptoms. One-quarter used illicit drugs in the past 60 days (48% any cocaine, 48% weekly marijuana, 44% any other drugs) with an average of 36 days for marijuana and 15 days for cocaine. After controlling for demographics, self-destructive avoidance was positively associated and spiritual coping was negatively associated with drug use. These findings suggest that assessment of drug abuse should be a routine part of care for older patients in HIV clinics. Furthermore, interventions designed to increase spiritual coping and decrease self-destructive avoidance may be particularly efficacious for HIV-infected older adults.}, Language = {eng}, Doi = {10.1037/a0031044}, Key = {fds253951} } @article{fds253942, Author = {Edelman, EJ and Moore, BA and Caffrey, S and Sikkema, KJ and Jones, ES and Schottenfeld, RS and Fiellin, DA and Fiellin, LE}, Title = {HIV testing and sexual risk reduction counseling in office-based buprenorphine/naloxone treatment.}, Journal = {Journal of Addiction Medicine}, Volume = {7}, Number = {6}, Pages = {410-416}, Year = {2013}, Month = {November}, ISSN = {1932-0620}, url = {http://www.ncbi.nlm.nih.gov/pubmed/24189173}, Abstract = {OBJECTIVES: We assessed the feasibility and preliminary efficacy of human immunodeficiency virus (HIV) testing with sexual risk reduction counseling for opioid-dependent patients initiating office-based buprenorphine/naloxone treatment. METHODS: We conducted a 14-week randomized, controlled trial with 30 patients (original target of 114) assigned to receive buprenorphine/naloxone induction/stabilization and HIV testing with Brief Sexual Risk Management (BSRM) or Enhanced Sexual Risk Management (ESRM). We evaluated process measures and compared outcomes at baseline and during the 3-month follow-up. RESULTS: Similar proportions of patients receiving BSRM and ESRM underwent HIV testing (93% vs 80%; P = 0.28) and completed counseling sessions (80% vs 67%; P = 0.40). Brief Sexual Risk Management sessions were shorter than ESRM sessions (15.4 vs 23.4 minutes), with comparable manual adherence (P = 0.80). Outcomes did not vary by BSRM versus ESRM. CONCLUSIONS: Although the recruitment of opioid-dependent patients with sexual risk behaviors is challenging, HIV testing with sexual risk reduction counseling in office-based buprenorphine/naloxone treatment practice is feasible. Interventions to decrease sexual risk behaviors among a segment of this population are necessary.}, Doi = {10.1097/adm.0b013e3182a3b603}, Key = {fds253942} } @article{fds253955, Author = {Eaton, LA and Pitpitan, EV and Kalichman, SC and Sikkema, KJ and Skinner, D and Watt, MH and Pieterse, D}, Title = {Men who report recent male and female sex partners in Cape Town, South Africa: an understudied and underserved population.}, Journal = {Archives of Sexual Behavior}, Volume = {42}, Number = {7}, Pages = {1299-1308}, Year = {2013}, Month = {October}, ISSN = {1573-2800}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23519592}, Keywords = {Adult • Alcohol Drinking • Data Collection • Epidemics • Female • HIV Infections • Homosexuality, Male • Humans • Male • Medically Underserved Area • Risk-Taking • Sex Offenses • Sexual Behavior • Sexual Partners • South Africa • Substance-Related Disorders • epidemiology • epidemiology* • statistics & numerical data • statistics & numerical data* • transmission}, Abstract = {The HIV/AIDS epidemic in South Africa has largely focused on the needs of heterosexual men and women. However, little is known about the sexual risk histories of men who have sex with both men and women (MSMW). Furthermore, we know very little about the psychosocial health needs or of the possibility of a syndemic (numerous interrelated epidemics) among MSMW. We surveyed 1,203 men attending drinking establishments in a township located in Cape Town, South Africa. We compared the behaviors and experiences of MSMW to men reporting only having sex with women (MSW). Twelve percent of the sample reported having sex with both men and women in the past 4 months. MSMW were twice as likely as MSW to report being HIV positive (10.5 vs. 4.6 %). MSW were more likely to be married than MSMW but reported similar numbers of female sex partners. MSMW were more likely to report a history of childhood sexual abuse, recent experienced and perpetrated physical and sexual partner violence, both receiving and giving sex for money, drugs, or shelter, and a recent STI. These factors were found to be interrelated among MSW but not MSMW. Although MSMW demonstrate considerable risk taking and report higher rates of HIV infection than MSW, their needs are largely unmet and underemphasized. Findings suggest the need to better understand factors contributing to sexual risk taking among MSMW. HIV prevention interventions should consider psychosocial health problems unique to MSMW residing in South African townships.}, Language = {eng}, Doi = {10.1007/s10508-013-0077-1}, Key = {fds253955} } @article{fds253943, Author = {Dietrich, J and Sikkema, K and Otwombe, KN and Sanchez, A and Nkala, B and de Bruyn, G and Van Der Watt and M and Gray, GE}, Title = {Multiple Levels of Influence in Predicting Sexual Activity and Condom Use Among Adolescents in Soweto, Johannesburg, South Africa}, Journal = {Journal of Hiv/Aids & Social Services}, Volume = {12}, Number = {3-4}, Pages = {404-423}, Publisher = {Informa UK Limited}, Year = {2013}, Month = {July}, ISSN = {1538-1501}, url = {http://dx.doi.org/10.1080/15381501.2013.819312}, Abstract = {HIV prevalence amongst 15-19 year olds in South Africa is 6.7% and 2.5% in females and males respectively. Using an interviewer-administered cross-sectional survey, we examined individual, interpersonal, family and community factors associated with sexual activity and condom use among 506 adolescents 16-18 years from Soweto, Johannesburg. The sample was mainly female (59%, n = 298). Using multivariate logistic regression, males (OR:2.6, CI: 1.4-4.8), older partners (OR:4.5, CI: 1.5-13.8), hazardous alcohol use (OR:2.4, CI: 1.1-5.2) and permissive attitudes about sex (OR:1.6, CI: 1.3-2.1) predicted sexual activity. A first partner at a younger age (OR:1.2, CI: 1.1-1.4) and having older partners (OR:0.29, CI: 0.13-0.68) predicted lack of condom use. For females, increasing age (OR:2.7 CI:1.4-5.5), older partners (OR: 3.3 CI:1.4-7.6), and permissive attitudes about sex (OR: 1.6 CI:1.2-2.1) predicted sexual activity. Multiple levels have to be addressed in developing HIV prevention programs for adolescents in Soweto. © 2013 Copyright Taylor and Francis Group, LLC.}, Doi = {10.1080/15381501.2013.819312}, Key = {fds253943} } @article{fds253948, Author = {Drabkin, AS and Sikkema, KJ and Wilson, PA and Meade, CS and Hansen, NB and DeLorenzo, A and Kochman, A and MacFarlane, JC and Watt, MH and Aunon, FM and Ranby, KW and Mayer, G}, Title = {Risk patterns preceding diagnosis among newly HIV-diagnosed men who have sex with men in New York City.}, Journal = {Aids Patient Care Stds}, Volume = {27}, Number = {6}, Pages = {333-341}, Year = {2013}, Month = {June}, ISSN = {1557-7449}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23730703}, Keywords = {Adult • CD4 Lymphocyte Count • Condoms • HIV Infections • Health Behavior • Homosexuality, Male • Humans • Interviews as Topic • Male • Mass Screening • New York City • Population Surveillance • Questionnaires • Risk Factors • Risk-Taking* • Socioeconomic Factors • Substance-Related Disorders • Time Factors • Unsafe Sex • Viral Load • Young Adult • diagnosis* • epidemiology • psychology • statistics & numerical data • statistics & numerical data* • utilization}, Abstract = {Men who have sex with men (MSM) are at high risk for contracting and transmitting HIV. They are increasingly encouraged to get tested, but understanding of the interplay between HIV testing and risk behavior is limited. One hundred fifty newly HIV-diagnosed (within past 3 months) MSM were recruited from a community clinic in New York City. Participants completed an interview assessing sexual behavior and substance use during the 3 months pre-diagnosis, current depressive symptoms, and prior HIV testing. HIV-related health characteristics at diagnosis were abstracted from medical records. Analyses examined factors associated with unprotected anal intercourse (UAI) in the 3 months pre-diagnosis, and with a negative HIV test in the 12 months pre-diagnosis. The sample was young (mean age=32.5, SD=8.8), ethnically diverse (62% racial/ethnic minority), low-income (71%≤$30,000/year), and educated (48% college/advanced degree). Most (95%) had a prior negative HIV test, 55% within the last 12 months. Significant risk behavior was reported, with 79% reporting UAI. UAI was associated with recent testing and use of substances during sexual behavior. Recent testing was associated with being employed/a student, having had UAI, and higher CD4 count. Implications for future research addressing perceived HIV risk, HIV testing utilization, and risk behavior are discussed.}, Language = {eng}, Doi = {10.1089/apc.2012.0313}, Key = {fds253948} } @article{fds254006, Author = {Pitpitan, EV and Kalichman, SC and Eaton, LA and Cain, D and Sikkema, KJ and Skinner, D and Watt, MH and Pieterse, D}, Title = {Gender-based violence, alcohol use, and sexual risk among female patrons of drinking venues in Cape Town, South Africa.}, Journal = {Journal of Behavioral Medicine}, Volume = {36}, Number = {3}, Pages = {295-304}, Year = {2013}, Month = {June}, ISSN = {1573-3521}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22526526}, Keywords = {Adult • Alcoholic Intoxication • Alcoholism • Binge Drinking • Developing Countries* • Female • Gender Identity* • HIV Infections • Health Surveys • Humans • Risk Factors • Social Environment* • South Africa • Spouse Abuse • Statistics as Topic • Unsafe Sex • Violence • complications • epidemiology • epidemiology* • prevention & control • psychology • psychology* • statistics & numerical data* • transmission*}, Abstract = {Gender-based violence is a well-recognized risk factor for HIV infection among women. Alcohol use is associated with both gender-based violence and sexual risk behavior, but has not been examined as a correlate of both in a context of both high HIV risk and hazardous drinking. The purpose of this paper is to examine the association between recent abuse by a sex partner with alcohol and sexual risk behavior among female patrons of alcohol serving venues in South Africa. Specifically, the aim of this study is to determine whether sexual risk behaviors are associated with gender-based violence after controlling for levels of alcohol use. We surveyed 1,388 women attending informal drinking establishments in Cape Town, South Africa to assess recent history of gender-based violence, drinking, and sexual risk behaviors. Gender-based violence was associated with both drinking and sexual risk behaviors after controlling for demographics among the women. A hierarchical logistic regression analysis showed that after controlling for alcohol use sexual risk behavior remained significantly associated with gender-based violence, particularly with meeting a new sex partner at the bar, recent STI diagnosis, and engaging in transactional sex, but not protected intercourse or number of partners. In South Africa where heavy drinking is prevalent women may be at particular risk of physical abuse from intimate partners as well as higher sexual risk. Interventions that aim to reduce gender-based violence and sexual risk behaviors must directly work to reduce drinking behavior.}, Language = {eng}, Doi = {10.1007/s10865-012-9423-3}, Key = {fds254006} } @article{fds253949, Author = {Puffer, ES and Pian, J and Sikkema, KJ and Ogwang-Odhiambo, RA and Broverman, SA}, Title = {Developing a family-based HIV prevention intervention in rural Kenya: challenges in conducting community-based participatory research.}, Journal = {Journal of Empirical Research on Human Research Ethics : Jerhre}, Volume = {8}, Number = {2}, Pages = {119-128}, Year = {2013}, Month = {April}, ISSN = {1556-2654}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23651936}, Keywords = {Advisory Committees* • Community Networks • Community-Based Participatory Research • Community-Institutional Relations* • Cooperative Behavior • Decision Making • Family • HIV Infections • Health Promotion • Health Resources • Humans • Kenya • Mental Health* • Power (Psychology) • Preventive Health Services • Residence Characteristics • Role • Rural Population • ethics* • prevention & control*}, Abstract = {Community-Based Participatory research (CBPR) introduces new ethical challenges for HIV prevention studies in low-resource international settings. We describe a CBPR study in rural Kenya to develop and pilot a family-based HIV prevention and mental health promotion intervention. Academic partners (APs) worked with a community advisory committee (CAC) during formative research, intervention development, and a pilot trial. Ethical challenges emerged related to: negotiating power imbalances between APs and the CAC; CAC members' shifting roles as part of the CAC and wider community; and anticipated challenges in decision making about sustainability. Factors contributing to ethical dilemmas included low access to education, scarcity of financial resources, and the shortage of HIV-related services despite high prevalence.}, Language = {eng}, Doi = {10.1525/jer.2013.8.2.119}, Key = {fds253949} } @article{fds253969, Author = {Sikkema, KJ and Ranby, KW and Meade, CS and Hansen, NB and Wilson, PA and Kochman, A}, Title = {Reductions in traumatic stress following a coping intervention were mediated by decreases in avoidant coping for people living with HIV/AIDS and childhood sexual abuse.}, Journal = {J Consult Clin Psychol}, Volume = {81}, Number = {2}, Pages = {274-283}, Year = {2013}, Month = {April}, ISSN = {1939-2117}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23025248}, Keywords = {Adaptation, Psychological • Adult • Child Abuse, Sexual • Child, Preschool • Female • HIV Infections • Humans • Male • Middle Aged • Psychotherapy, Group • Stress Disorders, Traumatic • Treatment Outcome • methods* • physiology* • psychology • rehabilitation*}, Abstract = {OBJECTIVE: To examine whether (a) Living in the Face of Trauma (LIFT), a group intervention to address coping with HIV and childhood sexual abuse (CSA), significantly reduced traumatic stress over a 1-year follow-up period more than an attention-matched support group comparison intervention; and (b) reductions in avoidant coping over time mediated reductions in traumatic stress. METHOD: In a randomized controlled trial, 247 participants completed measures of traumatic stress and avoidant coping at pre- and post intervention, and at 4-, 8-, and 12-month follow-ups. Latent growth curve modeling examined changes over the 5 time points; standardized path coefficients provide estimates of effects. RESULTS: As compared with the support intervention, the coping intervention led to a reduction in traumatic stress over time (b = -.20, p < .02). Participants in the coping intervention also reduced their use of avoidant coping strategies more than did participants in the support intervention (b = -.22, p < .05). Mediation analyses showed reductions in avoidant coping related to reductions in traumatic stress (b = 1.45, p < .001), and the direct effect of the intervention on traumatic stress was no longer significant (b = .04, ns), suggesting that changes in avoidant coping completely mediated intervention effects on traumatic stress. CONCLUSIONS: The LIFT intervention significantly reduced traumatic stress over time, and changes in avoidant coping strategies mediated this effect, suggesting a focus on current stressors and coping skills improvement are important components in addressing traumatic stress for adults living with HIV and CSA.}, Language = {eng}, Doi = {10.1037/a0030144}, Key = {fds253969} } @article{fds254008, Author = {Pitpitan, EV and Kalichman, SC and Eaton, LA and Cain, D and Sikkema, KJ and Watt, MH and Skinner, D and Pieterse, D}, Title = {Co-occurring psychosocial problems and HIV risk among women attending drinking venues in a South African township: a syndemic approach.}, Journal = {Annals of Behavioral Medicine}, Volume = {45}, Number = {2}, Pages = {153-162}, Year = {2013}, Month = {April}, ISSN = {1532-4796}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23054944}, Keywords = {Adult • African Continental Ancestry Group • Alcohol Drinking • Comorbidity • Eating • Female • HIV Infections • Humans • Longitudinal Studies • Mental Disorders • Prevalence • Risk Factors • South Africa • Substance-Related Disorders • Unsafe Sex • Violence • epidemiology • epidemiology* • psychology • psychology* • transmission}, Abstract = {In South Africa, women comprise the majority of HIV infections. Syndemics, or co-occurring epidemics and risk factors, have been applied in understanding HIV risk among marginalized groups.The purposes of this study are to apply the syndemic framework to examine psychosocial problems that co-occur among women attending drinking venues in South Africa and to test how the co-occurrence of these problems may exacerbate risk for HIV infection.Five hundred sixty women from a Cape Town township provided data on multiple psychosocial problems, including food insufficiency, depression, abuse experiences, problem drinking, and sexual behaviors.Bivariate associations among the syndemic factors showed a high degree of co-occurrence and regression analyses showed an additive effect of psychosocial problems on HIV risk behaviors.These results demonstrate the utility of a syndemic framework to understand co-occurring psychosocial problems among women in South Africa. HIV prevention interventions should consider the compounding effects of psychosocial problems among women.}, Language = {eng}, Doi = {10.1007/s12160-012-9420-3}, Key = {fds254008} } @article{fds326320, Author = {Wong, K and Somers, TJ and Babyak, M and Sikkema, KJ and Keefe, FJ}, Title = {PAIN AND EATING IN OVERWEIGHT AND OBESE INDIVIDUALS WITH OSTEOARTHRITIS: AN ECOLOGICAL MOMENTARY STUDY}, Journal = {Annals of Behavioral Medicine}, Volume = {45}, Pages = {S95-S95}, Publisher = {SPRINGER}, Year = {2013}, Month = {March}, Key = {fds326320} } @article{fds253944, Author = {Kotzé, M and Visser, M and Makin, J and Sikkema, K and Forsyth, B}, Title = {Psychosocial variables associated with coping of HIV-positive women diagnosed during pregnancy.}, Journal = {Aids and Behavior}, Volume = {17}, Number = {2}, Pages = {498-507}, Year = {2013}, Month = {February}, ISSN = {1090-7165}, url = {http://dx.doi.org/10.1007/s10461-012-0379-7}, Abstract = {To identify psychosocial variables related to the use of coping strategies by HIV-positive South African women diagnosed during pregnancy, structured interviews were conducted with 224 HIV-positive women at antenatal clinics over a period of 2 years. Two coping styles, active and avoidant coping, were assessed using an adapted version of the Brief COPE. Psychosocial variables associated with changes in coping over time were identified with mixed linear analysis. Increases in active coping were associated with decreasing levels of internalized stigma and depression, increasing self-esteem and positive social support, knowing someone who is living with HIV, being physically healthy and living above the poverty line. Increases in avoidant coping were associated with increasing internalized stigma and depression, lower levels of self-esteem, HIV-knowledge and lower levels of education. Recommendations are made for psychological support services to strengthen women's ability to cope and enhance their health and that of their infants.}, Doi = {10.1007/s10461-012-0379-7}, Key = {fds253944} } @article{fds253967, Author = {Hansen, NB and Harrison, B and Fambro, S and Bodnar, S and Heckman, TG and Sikkema, KJ}, Title = {The structure of coping among older adults living with HIV/AIDS and depressive symptoms.}, Journal = {Journal of Health Psychology}, Volume = {18}, Number = {2}, Pages = {198-211}, Year = {2013}, Month = {February}, ISSN = {1461-7277}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22453164}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological • Anxiety • Depression • Female • HIV Infections • Humans • Loneliness • Male • Middle Aged • Questionnaires • Self Efficacy • physiology* • psychology • psychology*}, Abstract = {One-third of adults living with HIV/AIDS are over the age of 50. This study evaluated the structure of coping among 307 older adults living with HIV/AIDS. Participants completed 61 coping items and measures of anxiety, depression, loneliness, and coping self-efficacy. Exploratory factor analyses retained 40 coping items loading on five specific first order factors (Distancing Avoidance, Social Support Seeking, Self-Destructive Avoidance, Spiritual Coping, and Solution-Focused Coping) and two general second order factors (Active and Avoidant Coping). Factors demonstrated good reliability and validity. Results suggest that general coping factors should be considered with specific factors when measuring coping among older adults.}, Language = {eng}, Doi = {10.1177/1359105312440299}, Key = {fds253967} } @article{fds253947, Author = {Kotzé, M and Visser, M and Makin, J and Sikkema, K and Forsyth, B}, Title = {The coping strategies used over a two-year period by HIV-positive women who had been diagnosed during pregnancy.}, Journal = {Aids Care Psychological and Socio Medical Aspects of Aids/Hiv}, Volume = {25}, Number = {6}, Pages = {695-701}, Year = {2013}, Month = {January}, ISSN = {0954-0121}, url = {http://dx.doi.org/10.1080/09540121.2013.772277}, Abstract = {Structured interviews were conducted with 224 HIV-positive women diagnosed during pregnancy, at antenatal clinics in Tshwane, South Africa, in order to investigate the use of coping strategies during the first two years after diagnosis. Interviews were conducted between one and four weeks after diagnosis during pregnancy, with three follow-up interviews conducted post-partum. Coping strategies were assessed with an adapted version of the Brief COPE. It was found that active coping was used more often than avoidant coping throughout the study period. Active coping increased over time, while avoidant coping decreased at first but increased again between 6 and 21 months after diagnosis. The most frequently used coping strategies included acceptance, direct action, positive reframing, religion and distraction. At first, women coped through internalised strategies. Over time, outward-focused strategies developed. Avoidant coping patterns differed from previous research indicating that women diagnosed during pregnancy deal with the consequences of HIV after the baby is born. Recommendations for mental health services are made.}, Doi = {10.1080/09540121.2013.772277}, Key = {fds253947} } @article{fds253953, Author = {Sipsma, H and Eloff, I and Makin, J and Finestone, M and Ebersohn, L and Visser, MJ and Sikkema, KJ and Allen, CAB and Ferreira, R and Forsyth, B}, Title = {Behavior and psychological functioning of young children of HIV-positive mothers in South Africa.}, Journal = {Aids Care Psychological and Socio Medical Aspects of Aids/Hiv}, Volume = {25}, Number = {6}, Pages = {721-725}, Year = {2013}, Month = {January}, ISSN = {1360-0451}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23514366}, Keywords = {Adult • Alcohol Drinking • Data Collection • Epidemics • Female • HIV Infections • Homosexuality, Male • Humans • Male • Medically Underserved Area • Risk-Taking • Sex Offenses • Sexual Behavior • Sexual Partners • South Africa • Substance-Related Disorders • epidemiology • epidemiology* • statistics & numerical data • statistics & numerical data* • transmission}, Abstract = {Adults with HIV are living longer due to earlier diagnosis and increased access to antiretroviral medications. Therefore, fewer young children are being orphaned and instead, are being cared for by parents who know they are HIV positive, although they may be asymptomatic. Presently, it is unclear whether the psychological functioning of these young children is likely to be affected or, alternatively, whether it is only when a mother is ill, that children suffer adverse effects. We, thus, aimed to compare the behavior and psychological functioning of young children (aged 6-10 years) of HIV-positive and HIV-negative mothers. We also aimed to examine the association between HIV status disclosure and child outcomes. This study uses cross-sectional data from the baseline assessment of a randomized controlled trial conducted in Tshwane, South Africa. Participants (n=509) and their children were recruited from area health clinics. Among the 395 mothers with HIV, 42% reported symptoms of HIV disease. Multivariate linear regression models suggested that after adjusting for socio-demographic characteristics, children of HIV-positive mothers had significantly greater externalizing behaviors than children of HIV-negative mothers. Importantly, children whose mothers were symptomatic had greater internalizing and externalizing behaviors compared with children of HIV-negative mothers, but this was not true for children of asymptomatic mothers. Additionally, among children of HIV-positive mothers, those who had been told their mothers were sick compared with children who had been told nothing had less internalizing and externalizing behaviors and improved daily living skills. This study, therefore, provides evidence that maternal HIV disease can affect the behaviors of young children in South Africa but, importantly, only when the mothers are symptomatic from their disease. Furthermore, results suggest that disclosure of maternal illness but not HIV status was associated with improved behavior and psychological functioning among young children.}, Language = {eng}, Doi = {10.1080/09540121.2013.779627}, Key = {fds253953} } @article{fds218619, Author = {KJ Sikkema and KW Ranby and CS Meade and NB Hansen and PA Wilson and A Kochman}, Title = {Reductions in traumatic stress following a coping intervention were mediated by decreases in avoidant coping for people living with HIV/AIDS and childhood sexual abuse}, Journal = {Journal of consulting and clinical psychology}, Volume = {81}, Number = {2}, Pages = {274-283}, Year = {2013}, Abstract = {OBJECTIVE: To examine whether (a) Living in the Face of Trauma (LIFT), a group intervention to address coping with HIV and childhood sexual abuse (CSA), significantly reduced traumatic stress over a 1-year follow-up period more than an attention-matched support group comparison intervention; and (b) reductions in avoidant coping over time mediated reductions in traumatic stress. METHODS: In a randomized controlled trial, 247 participants completed measures of traumatic stress and avoidant coping at pre- and post intervention, and at 4-, 8-, and 12-month follow-ups. Latent growth curve modeling examined changes over the 5 time points; standardized path coefficients provide estimates of effects. RESULTS: As compared with the support intervention, the coping intervention led to a reduction in traumatic stress over time (b = -.20, p < .02). Participants in the coping intervention also reduced their use of avoidant coping strategies more than did participants in the support intervention (b = -.22, p < .05). Mediation analyses showed reductions in avoidant coping related to reductions in traumatic stress (b = 1.45, p < .001), and the direct effect of the intervention on traumatic stress was no longer significant (b = .04, ns), suggesting that changes in avoidant coping completely mediated intervention effects on traumatic stress. CONCLUSION: The LIFT intervention significantly reduced traumatic stress over time, and changes in avoidant coping strategies mediated this effect, suggesting a focus on current stressors and coping skills improvement are important components in addressing traumatic stress for adults living with HIV and CSA.}, Key = {fds218619} } @article{fds218620, Author = {KJ Sikkema and NB Hansen and CS Meade and A Kochman and AM Fox}, Title = {Psychosocial predictors of sexual HIV transmission risk behavior among HIV-positive adults with a sexual abuse history in childhood}, Journal = {Archives of Sexual Behavior}, Volume = {38}, Number = {1}, Pages = {121-134}, Year = {2013}, Abstract = {Childhood sexual abuse (CSA) is associated with HIV sexual risk behavior. Although many psychosocial correlates of sexual risk among HIV-positive persons have been identified, studies predicting continued risk among HIV-positive adults with histories of CSA are limited. This cross-sectional study identified variables predictive of sexual transmission risk behavior among an ethnically diverse sample of 256 HIV-positive adults (women and men who have sex with men; MSM) with CSA histories. Participants were assessed for trauma symptoms, shame related to HIV and sexual trauma, substance use, coping style, and sexual risk behavior. Logistic regression analyses were conducted to identify variables predictive of unprotected sexual behavior in the past 4 months. Unprotected sex was significantly associated with substance use and trauma-related behavioral difficulties among women and men, and less spiritual coping among men. Unprotected sex with HIV negative or serostatus unknown partners was significantly associated with greater trauma-related behavioral difficulties, more HIV-related shame, and fewer active coping strategies. Thus, trauma symptoms, shame, coping style, and substance use were significantly associated with sexual risk behavior among HIV-positive adults with histories of CSA, with models of prediction differing by gender and partner serostatus. HIV prevention intervention for persons with HIV and CSA histories should address trauma-related behavioral difficulties and enhance coping skills to reduce sexual transmission risk behavior.}, Key = {fds218620} } @article{fds253946, Author = {Kalichman, SC and Watt, M and Sikkema, K and Skinner, D and Pieterse, D}, Title = {Food insufficiency, substance use, and sexual risks for HIV/AIDS in informal drinking establishments, Cape Town, South Africa.}, Journal = {Journal of Urban Health : Bulletin of the New York Academy of Medicine}, Volume = {89}, Number = {6}, Pages = {939-951}, Year = {2012}, Month = {December}, ISSN = {1099-3460}, url = {http://dx.doi.org/10.1007/s11524-012-9686-6}, Abstract = {HIV/AIDS is concentrated in impoverished communities. Two critical aspects of poverty are food insufficiency and substance abuse, and both are associated with sexual risks for HIV/AIDS in southern Africa. The current study is the first to examine both hunger and substance use in relation to sexual risks for HIV infection in South African alcohol serving establishments. Anonymous venue-based intercept surveys were completed by men (n = 388) and women (n = 407) patrons of six informal drinking places (e.g., shebeens) in Cape Town, South Africa. Food insufficiency and its more extreme form hunger were common in the sample, with 24 % of men and 53 % of women experiencing hunger in the previous 4 months. Multiple regression analyses showed that quantity of alcohol use was related to higher rates of unprotected sex for men and women. Trading sex to meet survival needs was related to food insufficiency and methamphetamine use among men but not women. Food insufficiency and substance use may both contribute to HIV risks in South African shebeens. However, the influence of hunger and substance use on sexual risks varies for men and women. Interventions to reduce HIV transmission risks may be bolstered by reducing both food insufficiency and substance use.}, Doi = {10.1007/s11524-012-9686-6}, Key = {fds253946} } @article{fds254015, Author = {Visser, M and Finestone, M and Sikkema, K and Boeving-Allen, A and Ferreira, R and Eloff, I and Forsyth, B}, Title = {Development and piloting of a mother and child intervention to promote resilience in young children of HIV-infected mothers in South Africa.}, Journal = {Evaluation and Program Planning}, Volume = {35}, Number = {4}, Pages = {491-500}, Year = {2012}, Month = {November}, ISSN = {0149-7189}, url = {http://dx.doi.org/10.1016/j.evalprogplan.2012.04.001}, Abstract = {This paper describes the process of developing a parallel intervention for HIV-positive mothers and their young children (6-10 years) with a view to strengthening the relationship between them. Strong mother-child relationships can contribute to enhanced psychological resilience in children. The intervention was developed through action research, involving a situation analysis based on focus group discussions; intervention planning, piloting the intervention and a formative evaluation of the intervention. Participants supplied feedback regarding the value of the intervention in mother-child relationships. The findings obtained from the formative evaluation were used to refine the intervention. Two parallel programmes for mothers and children (15 sessions each) were followed by 10 joint sessions. The intervention for mothers focused on maternal mental health and the strengthening of their capacity to protect and care for their young children. The intervention for children addressed the development of their self-esteem, interpersonal relationships and survival skills. The formative evaluation provided evidence of good participation, support and group cohesion. Qualitative feedback indicated that the activities stimulated mother-child interaction. A similar intervention can easily be applied elsewhere using the detailed manual. The insights gained and lessons learnt related to mother and child interaction within an HIV-context that emerged from this research, can be valuable in other settings, both in Sub-Saharan Africa and elsewhere.}, Doi = {10.1016/j.evalprogplan.2012.04.001}, Key = {fds254015} } @article{fds254020, Author = {Meade, CS and Watt, MH and Sikkema, KJ and Deng, LX and Ranby, KW and Skinner, D and Pieterse, D and Kalichmann, SC}, Title = {Methamphetamine use is associated with childhood sexual abuse and HIV sexual risk behaviors among patrons of alcohol-serving venues in Cape Town, South Africa.}, Journal = {Drug Alcohol Depend}, Volume = {126}, Number = {1-2}, Pages = {232-239}, Year = {2012}, Month = {November}, ISSN = {1879-0046}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22717338}, Keywords = {Adolescent • Adult • African Continental Ancestry Group • Alcohol Drinking • Amphetamine-Related Disorders • Central Nervous System Stimulants* • Child Abuse, Sexual • Data Interpretation, Statistical • Demography • European Continental Ancestry Group • Female • HIV Infections • Humans • Male • Methamphetamine* • Middle Aged • Sex Factors • Socioeconomic Factors • South Africa • Unsafe Sex • Violence • Young Adult • complications* • epidemiology • psychology* • transmission}, Abstract = {BACKGROUND: South Africa's Western Cape has experienced a dramatic increase in methamphetamine ("meth") use over the past decade. There is concern that meth may further fuel the HIV epidemic in this country because of its association with risky sexual behaviors. This study describes the prevalence of meth use and its relation to HIV sexual risk behaviors among patrons of alcohol-serving venues. METHODS: Participants (N=3328) were surveyed in 12 venues in a mixed race township. Logistic regression models were used to examine the relations between meth use and sexual risk behaviors, and structural equation models were used to test whether meth use mediates the relationship between childhood sexual abuse and current sexual risk. RESULTS: Meth use in the past 4 months was more common among Coloured than Black persons (10.5% vs. 3.5%). Meth users were more likely than non users to use marijuana, inhalants, and injection drugs, have a history of childhood sexual and/or physical abuse, and experience and/or perpetrate intimate partner violence. Among both men and women, meth use was associated with greater odds of engaging in sexual risk behaviors, and meth use partially mediated the relationships between childhood sexual abuse and all sexual risk behaviors. CONCLUSIONS: Meth users in this setting are at increased risk for HIV due to their greater likelihood of engaging in sexual risk behaviors and being in violent relationships. There is an urgent need to provide targeted HIV prevention and substance abuse treatment to meth users living in townships in Cape Town.}, Language = {eng}, Doi = {10.1016/j.drugalcdep.2012.05.024}, Key = {fds254020} } @article{fds253956, Author = {Meade, CS and Watt, MH and Sikkema, KJ and Deng, LX and Ranby, KW and Skinner, D and Pieterse, D and Kalichman, SC}, Title = {Methamphetamine use is associated with sexual abuse and HIV sexual risk behaviours among patrons of alcohol serving venues in Cape Town, South Africa}, Journal = {Journal of the International Aids Society}, Volume = {15}, Pages = {89-90}, Publisher = {JOHN WILEY & SONS LTD}, Year = {2012}, Month = {October}, ISSN = {1758-2652}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000310588200173&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Key = {fds253956} } @article{fds254013, Author = {Pitpitan, EV and Kalichman, SC and Eaton, LA and Sikkema, KJ and Watt, MH and Skinner, D}, Title = {Gender-based violence and HIV sexual risk behavior: alcohol use and mental health problems as mediators among women in drinking venues, Cape Town.}, Journal = {Social Science & Medicine}, Volume = {75}, Number = {8}, Pages = {1417-1425}, Year = {2012}, Month = {October}, ISSN = {1873-5347}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22832324}, Keywords = {Adult • Alcohol Drinking • Female • Follow-Up Studies • HIV Infections • Humans • Mental Disorders • Middle Aged • Prospective Studies • Qualitative Research • Risk Factors • Risk-Taking* • Sexual Behavior* • Socioeconomic Factors • South Africa • Violence • Young Adult • epidemiology • epidemiology* • statistics & numerical data*}, Abstract = {Gender-based violence is a key determinant of HIV infection among women in South Africa as elsewhere. However, research has not examined potential mediating processes to explain the link between experiencing abuse and engaging in HIV sexual risk behavior. Previous studies suggest that alcohol use and mental health problems may explain how gender-based violence predicts sexual risk. In a prospective study, we examined whether lifetime history of gender-based violence indirectly affects future sexual risk behavior through alcohol use, depression and post-traumatic stress disorder (PTSD) in a high-risk socio-environmental context. We recruited a cohort of 560 women from alcohol drinking venues in a Cape Town, South African township. Participants completed computerized interviews at baseline and 4 months later. We tested prospective mediating associations between gender-based violence, alcohol use, depression, PTSD, and sexual risk behavior. There was a significant indirect effect of gender-based violence on sexual risk behavior through alcohol use, but not mental health problems. Women who were physically and sexually abused drank more, which in turn predicted more unprotected sex. We did not find a mediated relationship between alcohol use and sexual risk behavior through the experience of recent abuse or mental health problems. Alcohol use explains the link between gender-based violence and sexual risk behavior among women attending drinking venues in Cape Town, South Africa. Efforts to reduce HIV risk in South Africa by addressing gender-based violence must also address alcohol use.}, Language = {eng}, Doi = {10.1016/j.socscimed.2012.06.020}, Key = {fds254013} } @article{fds254014, Author = {Watt, MH and Aunon, FM and Skinner, D and Sikkema, KJ and Macfarlane, JC and Pieterse, D and Kalichman, SC}, Title = {Alcohol-serving venues in South Africa as sites of risk and potential protection for violence against women.}, Journal = {Substance Use & Misuse}, Volume = {47}, Number = {12}, Pages = {1271-1280}, Year = {2012}, Month = {October}, ISSN = {1532-2491}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22738267}, Keywords = {Adolescent • Adult • Alcohol Drinking* • Alcoholic Beverages • Battered Women* • Female • Humans • Male • Middle Aged • Qualitative Research • Restaurants* • Risk Factors • South Africa • Violence • Young Adult • prevention & control* • supply & distribution*}, Abstract = {This qualitative study explores alcohol-serving venues as sites of risk or protection from violence against women (VAW) in one South African community. In 2010, we conducted in-depth interviews with 31 female patrons, 13 male patrons and 11 venue staff, and conducted structured observations in six alcohol venues. VAW was a common experience and venues contributed to risk through aggression, negative attitudes toward women, risks leaving the venues, and owners tolerating VAW. Concurrently, venues offered potential to avoid VAW through perceived safety and owner protection. Results highlight the influence of the venue environment and importance of addressing the setting of alcohol consumption.}, Language = {eng}, Doi = {10.3109/10826084.2012.695419}, Key = {fds254014} } @article{fds254022, Author = {Puffer, ES and Drabkin, AS and Stashko, AL and Broverman, SA and Ogwang-Odhiambo, RA and Sikkema, KJ}, Title = {Orphan status, HIV risk behavior, and mental health among adolescents in rural Kenya.}, Journal = {Journal of Pediatric Psychology}, Volume = {37}, Number = {8}, Pages = {868-878}, Year = {2012}, Month = {September}, ISSN = {1465-735X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22728899}, Keywords = {Adolescent • Adolescent Behavior • Caregivers • Child • Child, Orphaned • Communication • Female • HIV Infections • HIV Seropositivity • Health Knowledge, Attitudes, Practice • Humans • Kenya • Male • Mental Health* • Parental Death • Risk Factors • Risk-Taking* • Rural Health • Rural Population • Self Efficacy • Sexual Behavior • Social Support • Socioeconomic Factors • psychology* • statistics & numerical data}, Abstract = {To examine orphan status, mental health, social support, and HIV risk among adolescents in rural Kenya.Randomly selected adolescents aged 10-18 years completed surveys assessing sexual activity, sex-related beliefs and self-efficacy, mental health, social support, caregiver-child communication, time since parental death, and economic resources. Analysis of covariance and regression analyses compared orphans and nonorphans; orphan status was tested as a moderator between well-being and HIV risk.Orphans reported poorer mental health, less social support, and fewer material resources. They did not differ from nonorphans on HIV risk indicators. Longer time since parental death was associated with poorer outcomes. In moderator analyses, emotional problems and poorer caregiver-youth communication were more strongly associated with lower sex-related self-efficacy for orphans.Orphans are at higher risk for psychosocial problems. These problems may affect orphans' self-efficacy for safer sex practices more than nonorphans. Decreased HIV risk could be one benefit of psychosocial interventions for orphans.}, Language = {eng}, Doi = {10.1093/jpepsy/jss077}, Key = {fds254022} } @article{fds254019, Author = {Watt, MH and Ranby, KW and Meade, CS and Sikkema, KJ and MacFarlane, JC and Skinner, D and Pieterse, D and Kalichman, SC}, Title = {Posttraumatic stress disorder symptoms mediate the relationship between traumatic experiences and drinking behavior among women attending alcohol-serving venues in a South African township.}, Journal = {J Stud Alcohol Drugs}, Volume = {73}, Number = {4}, Pages = {549-558}, Year = {2012}, Month = {July}, ISSN = {1938-4114}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22630793}, Keywords = {Adolescent • Adult • Aged • Alcohol Drinking • Alcoholic Beverages • Alcoholism • Cohort Studies • Cross-Sectional Studies • Female • Food Services* • Humans • Middle Aged • Prevalence • Severity of Illness Index • Sex Offenses • South Africa • Stress Disorders, Post-Traumatic • Stress, Psychological • Suburban Health • Violence • Wounds and Injuries • Young Adult • epidemiology • ethnology • physiopathology • psychology • psychology* • supply & distribution*}, Abstract = {OBJECTIVE: South Africa has high rates of traumatic experiences and alcohol abuse or dependence, especially among women. Traumatic experiences often result in symptoms of posttraumatic stress disorder (PTSD), and PTSD has been associated with hazardous drinking. This article examines the relationship between traumatic events and hazardous drinking among women who patronized alcohol-serving venues in South Africa and examines PTSD as a mediator of this relationship. METHOD: A total of 560 women were recruited from a Cape Town township. They completed a computerized assessment that included alcohol consumption, history of traumatic events, and PTSD symptoms. Mediation analysis examined whether PTSD symptoms mediated the relationship between the number of traumatic event categories experienced (range: 0-7) and drinking behavior. RESULTS: The mean Alcohol Use Disorders Identification Test score in the sample was 12.15 (range: 0-34, SD = 7.3), with 70.9% reaching criteria for hazardous drinking (AUDIT > 8). The mean PTSD score was 36.32 (range: 17-85, SD = 16.3),with 20.9% meeting symptom criteria for PTSD (PTSD Checklist with 20.9% meeting symptom criteria for PTSD (PTSD Checklist-Civilian Version ≥ 50). Endorsement of traumatic experiences was high, including adult emotional (51.8%), physical (49.6%), and sexual (26.3%) abuse; childhood physical (35.0%) and sexual (25.9%) abuse; and other types of trauma (83%). All categories of traumatic experiences, except the "other" category, were associated with hazardous drinking. PTSD symptoms mediated 46% of the relationship between the number of traumatic categories experienced and drinking behavior. CONCLUSIONS: Women reported high rates of hazardous drinking and high levels of PTSD symptoms, and most had some history of traumatic events. There was a strong relationship between traumatic exposure and drinking levels, which was largely mediated by PTSD symptoms. Substance use interventions should address histories of trauma in this population, where alcohol may be used in part to cope with past traumas.}, Language = {eng}, Doi = {10.15288/jsad.2012.73.549}, Key = {fds254019} } @article{fds254012, Author = {Pitpitan, EV and Kalichman, SC and Eaton, LA and Cain, D and Sikkema, KJ and Skinner, D and Watt, MH and Pieterse, D}, Title = {AIDS-related stigma, HIV testing, and transmission risk among patrons of informal drinking places in Cape Town, South Africa.}, Journal = {Annals of Behavioral Medicine}, Volume = {43}, Number = {3}, Pages = {362-371}, Year = {2012}, Month = {June}, ISSN = {1532-4796}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22367752}, Keywords = {Acquired Immunodeficiency Syndrome • Adult • Alcohol Drinking • Female • HIV Infections • Health Knowledge, Attitudes, Practice* • Humans • Male • Risk Reduction Behavior • Risk-Taking* • Sexual Behavior • Social Environment • Social Stigma* • South Africa • diagnosis • psychology • psychology* • transmission}, Abstract = {AIDS-related stigma as a barrier to HIV testing has not been examined within the context of high at risk environments such as drinking venues. Of particular importance is whether AIDS-related stigma is associated with HIV transmission risks among people who have never been tested for HIV.We examined: (1) AIDS-related stigma as a barrier to testing, controlling for other potential barriers, and (2) whether stigma is associated with HIV risks among HIV-untested individuals.We surveyed 2,572 individuals attending informal drinking establishments in Cape Town, South Africa to assess HIV testing status, AIDS-related stigma endorsement, and HIV transmission sexual risk behavior.Endorsement of AIDS-related stigma was negatively associated with HIV lifetime testing. In addition, stigma endorsement was associated with higher HIV transmission risks.AIDS-related stigma must be addressed in HIV prevention campaigns across South Africa. Antistigma messages should be integrated with risk reduction counseling and testing.}, Language = {eng}, Doi = {10.1007/s12160-012-9346-9}, Key = {fds254012} } @article{fds254052, Author = {Neufeld, SAS and Sikkema, KJ and Lee, RS and Kochman, A and Hansen, NB}, Title = {The development and psychometric properties of the HIV and Abuse Related Shame Inventory (HARSI).}, Journal = {Aids and Behavior}, Volume = {16}, Number = {4}, Pages = {1063-1074}, Year = {2012}, Month = {May}, ISSN = {1573-3254}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22065235}, Keywords = {Adolescent • Adult • Child Abuse, Sexual • Depression • Female • HIV Seropositivity • Health Status Indicators • Humans • Male • Medication Adherence • Personality Inventory • Prejudice • Psychometrics • Quality of Life • Questionnaires • Reproducibility of Results • Sexual Behavior • Shame* • United States • Young Adult • epidemiology • psychology* • statistics & numerical data}, Abstract = {Shame has been shown to predict sexual HIV transmission risk behavior, medication non-adherence, symptomatic HIV or AIDS, and symptoms of depression and PTSD. However, there remains a dearth of tools to measure the specific constructs of HIV-related and sexual abuse-related shame. To ameliorate this gap, we present a 31-item measure that assesses HIV and sexual abuse-related shame, and the impact of shame on HIV-related health behaviors. A diverse sample of 271 HIV-positive men and women who were sexually abused as children completed the HIV and Abuse Related Shame Inventory (HARSI) among other measures. An exploratory factor analysis supported the retention of three-factors, explaining 56.7% of the sample variance. These internally consistent factors showed good test-retest reliability, and sound convergent and divergent validity using eight well-established HIV specific and general psychosocial criterion measures. Unlike stigma or discrimination, shame is potentially alterable through individually-focused interventions, making the measurement of shame clinically meaningful.}, Language = {eng}, Doi = {10.1007/s10461-011-0086-9}, Key = {fds254052} } @article{fds253959, Author = {Wilson, SM and Watt, MH and Masenga, GG and Wilkinson, JP and Sikkema, KJ}, Title = {OBSTETRIC FISTULA IS ASSOCIATED WITH DEPRESSION, PTSD, AND NEGATIVE COPING}, Journal = {Annals of Behavioral Medicine}, Volume = {43}, Pages = {S36-S36}, Publisher = {SPRINGER}, Year = {2012}, Month = {April}, ISSN = {0883-6612}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000302092400138&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Key = {fds253959} } @article{fds253963, Author = {Pitpitan, EV and Kalichman, SC and Eaton, LA and Cain, D and Sikkema, KJ and Skinner, D and Watt, MH and Desiree, P}, Title = {THE ASSOCIATION BETWEEN AIDS-RELATED STIGMA AND HIV TESTING AND TRANSMISSION RISK AMONG PATRONS OF INFORMAL DRINKING PLACES IN CAPE TOWN, SOUTH AFRICA}, Journal = {Annals of Behavioral Medicine}, Volume = {43}, Pages = {S154-S154}, Publisher = {SPRINGER}, Year = {2012}, Month = {April}, ISSN = {0883-6612}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000302092400597&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Key = {fds253963} } @article{fds254010, Author = {Watt, MH and Aunon, FM and Skinner, D and Sikkema, KJ and Kalichman, SC and Pieterse, D}, Title = {"Because he has bought for her, he wants to sleep with her": alcohol as a currency for sexual exchange in South African drinking venues.}, Journal = {Social Science & Medicine}, Volume = {74}, Number = {7}, Pages = {1005-1012}, Year = {2012}, Month = {April}, ISSN = {1873-5347}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22326304}, Keywords = {Adolescent • Adult • Alcohol Drinking* • Choice Behavior • Female • HIV Infections • Humans • Interpersonal Relations • Male • Middle Aged • Risk-Taking • Sexual Behavior* • South Africa • Young Adult • prevention & control}, Abstract = {Previous research has documented the practice of transactional sex in sub-Saharan Africa and its association with gender-based violence, gender inequalities and HIV risk. At the same time, it has been suggested that women may use transactional sex to obtain a greater sense of control over their lives and their sexualities, and to garner access to resources. The aim of this study was to better understand the practice of exchanging alcohol for sex in alcohol-serving venues in a township in Cape Town, South Africa. Data were collected between June 2009 and October 2010. Six venues were included and observations were conducted in each for four one-week periods over the course of a year. In-depth qualitative interviews included 31 women and 13 men whom interviewers had observed as regular venue customers. Follow-up interviews were conducted with 24 respondents to explore emerging themes. Interviews were recorded and transcribed. Using a grounded theory approach, Atlas.ti was used to code transcripts, field notes, and analytical memos written about each document. Results revealed that alcohol was commonly used as a currency of sexual exchange in this setting, and both women and men understood that accepting alcohol from a man implied consent for sexual favors. Women reported a sense of agency in participating in the transactional sex dynamic, especially when they were able to manipulate it to meet their own ends without fulfilling the men's sexual expectations. At the same time, data revealed that the norm of transactional sex reinforced the undervaluing and commoditization of women. As identified elsewhere, transactional sex put both women and men at greater risk of HIV through multiple partners and inconsistent use of condoms, and the possibility of rape. Interventions are needed to address sexual risk behaviors and substance use within this context to prevent new HIV infections.}, Language = {eng}, Doi = {10.1016/j.socscimed.2011.12.022}, Key = {fds254010} } @article{fds254021, Author = {Puffer, ES and Watt, MH and Sikkema, KJ and Ogwang-Odhiambo, RA and Broverman, SA}, Title = {The protective role of religious coping in adolescents' responses to poverty and sexual decision-making in rural Kenya.}, Journal = {Journal of Research on Adolescence}, Volume = {22}, Number = {1}, Pages = {1-7}, Year = {2012}, Month = {March}, ISSN = {1050-8392}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22505794}, Keywords = {Adult • Alcoholic Intoxication • Alcoholism • Binge Drinking • Developing Countries* • Female • Gender Identity* • HIV Infections • Health Surveys • Humans • Risk Factors • Social Environment* • South Africa • Spouse Abuse • Statistics as Topic • Unsafe Sex • Violence • complications • epidemiology • epidemiology* • prevention & control • psychology • psychology* • statistics & numerical data* • transmission*}, Abstract = {In this study, we explored how adolescents in rural Kenya apply religious coping in sexual decision-making in the context of high rates of poverty and Human Immunodeficiency Virus (HIV). Semi-structured interviews were conducted with 34 adolescents. One-third (13) reported religious coping related to economic stress, HIV, or sexual decision-making; the majority (29) reported religious coping with these or other stressors. Adolescents reported praying for God to partner with them to engage in positive behaviors, praying for strength to resist unwanted behaviors, and passive strategies characterized by waiting for God to provide resources or protection from HIV. Adolescents in Sub-Saharan Africa may benefit from HIV prevention interventions that integrate and build upon their use of religious coping.}, Language = {ENG}, Doi = {10.1111/j.1532-7795.2011.00760.x}, Key = {fds254021} } @article{fds254050, Author = {Eaton, LA and Kalichman, SC and Sikkema, KJ and Skinner, D and Watt, MH and Pieterse, D and Pitpitan, EV}, Title = {Pregnancy, alcohol intake, and intimate partner violence among men and women attending drinking establishments in a Cape Town, South Africa township.}, Journal = {Journal of Community Health}, Volume = {37}, Number = {1}, Pages = {208-216}, Year = {2012}, Month = {February}, ISSN = {1573-3610}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21744297}, Keywords = {Adult • Alcohol Drinking • Cross-Sectional Studies • Ethanol • Female • Humans • Male • Pregnancy • Pregnant Women • Sex Offenses • Social Behavior • South Africa • Spouse Abuse* • epidemiology • poisoning • psychology • psychology* • statistics & numerical data}, Abstract = {The highest rates of fetal alcohol syndrome worldwide can be found in South Africa. Particularly in impoverished townships in the Western Cape, pregnant women live in environments where alcohol intake during pregnancy has become normalized and interpersonal violence (IPV) is reported at high rates. For the current study we sought to examine how pregnancy, for both men and women, is related to alcohol use behaviors and IPV. We surveyed 2,120 men and women attending drinking establishments in a township located in the Western Cape of South Africa. Among women 13.3% reported being pregnant, and among men 12.0% reported their partner pregnant. For pregnant women, 61% reported attending the bar that evening to drink alcohol and 26% reported both alcohol use and currently experiencing IPV. Daily or almost daily binge drinking was reported twice as often among pregnant women than non-pregnant women (8.4% vs. 4.2%). Men with pregnant partners reported the highest rates of hitting sex partners, forcing a partner to have sex, and being forced to have sex. High rates of alcohol frequency, consumption, binge drinking, consumption and binge drinking were reported across the entire sample. In general, experiencing and perpetrating IPV were associated with alcohol use among all participants except for men with pregnant partners. Alcohol use among pregnant women attending shebeens is alarmingly high. Moreover, alcohol use appears to be an important factor in understanding the relationship between IPV and pregnancy. Intensive, targeted, and effective interventions for both men and women are urgently needed to address high rates of drinking alcohol among pregnant women who attend drinking establishments.}, Language = {eng}, Doi = {10.1007/s10900-011-9438-7}, Key = {fds254050} } @article{fds254009, Author = {Ebersöhn, L and Eloff, I and Finestone, M and van Dullemen, I and Sikkema, K and Forsyth, B}, Title = {Drawing on resilience: Piloting the utility of the Kinetic Family Drawing to measure resilience in children of HIV-positive mothers}, Journal = {South African Journal of Education}, Volume = {32}, Number = {4}, Pages = {331-348}, Publisher = {Education Association of South Africa}, Year = {2012}, Month = {January}, ISSN = {0256-0100}, url = {http://dx.doi.org/10.15700/saje.v32n4a660}, Abstract = {In this article we describe how using a visual, child-friendly measure of resilience in a randomised control trial (RCT), the Kgolo Mmogo (KM) project, resulted in representative insights on resilience in a mother-child relationship where the mother is HIV-positive. We used the existing psychological method Kinetic Family Drawing (KFD) to measure resilience of young children in the qualitative phase of the concurrent mixed method RCT as the children represent cultural groups for whom standardized measures have not been developed. We use the case example of baseline KM assessment data of 6 year olds (n = 11; 3 female, 8 male). The results of the study demonstrate that the visual and qualitative data from children (KFD) added to quantitative information obtained from mothers (Vineland Adaptive Behavior Scale, VABS). Additional information from the KFD had interpretation value for VABS scores and provided a child's perspective regarding resilience. Contrasting information from the KFD problematized mothers' perspectives as indicated in the VABS. The absence of significant information in KFD results regarding VABS sub-domains indicates differences in the cultural/contextual conceptualization of resilience. This exploratory study indicates initial support for the cross-cultural utility of the KFD to measure resilience in young children faced with adversity. © 2012 EASA.}, Doi = {10.15700/saje.v32n4a660}, Key = {fds254009} } @article{fds254011, Author = {Mundell, JP and Visser, MJ and Makin, JD and Forsyth, BW and Sikkema, KJ}, Title = {Support group processes: Perspectives from HIV-infected women in South Africa.}, Journal = {Qualitative Research in Psychology}, Volume = {9}, Number = {2}, Pages = {173-187}, Year = {2012}, Month = {January}, ISSN = {1478-0887}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22514790}, Keywords = {Adult • Alcoholic Intoxication • Alcoholism • Binge Drinking • Developing Countries* • Female • Gender Identity* • HIV Infections • Health Surveys • Humans • Risk Factors • Social Environment* • South Africa • Spouse Abuse • Statistics as Topic • Unsafe Sex • Violence • complications • epidemiology • epidemiology* • prevention & control • psychology • psychology* • statistics & numerical data* • transmission*}, Abstract = {This study examined the experiences and perceived benefits of support group participation among HIV-infected women in South Africa. From a qualitative analysis of responses, key psychological processes through which support groups are potentially beneficial were identified. These processes included: identification; modeling; acceptance; and empowerment. The participants' consequent life changes were explored in order to associate these processes with the positive outcomes of support group participation. Through understanding the relationship between the psychological processes within a support group setting and the potential benefits, and by targeting these processes in the development and implementation of future support group interventions, a framework is provided for achieving positive outcomes associated with support group participation.}, Language = {ENG}, Doi = {10.1080/14780887.2010.500350}, Key = {fds254011} } @misc{fds254053, Author = {Njau, B and Watt, MH and Ostermann, J and Manongi, R and Sikkema, KJ}, Title = {Perceived acceptability of home-based couples voluntary HIV counseling and testing in Northern Tanzania.}, Journal = {Aids Care Psychological and Socio Medical Aspects of Aids/Hiv}, Volume = {24}, Number = {4}, Pages = {413-419}, Year = {2012}, Month = {January}, ISSN = {1360-0451}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21939369}, Keywords = {Adult • Counseling* • Emotional Intelligence • Female • Focus Groups • HIV Infections* • HIV Seropositivity • Health Services Needs and Demand • Home Care Services • Humans • Interpersonal Relations • Male • Mass Screening* • Middle Aged • Patient Acceptance of Health Care • Rural Health • Social Perception* • Social Stigma • Spouses • Tanzania • diagnosis • epidemiology • methods • organization & administration • organization & administration* • prevention & control • psychology • psychology*}, Abstract = {It is estimated that 5.6% of the Tanzanian population ages 15-49 are infected with HIV, but only 30% of adults have ever had an HIV test. Couples' testing has proven to increase testing coverage and introduce HIV prevention, but barriers include access to testing services and unequal gender dynamics in relationships. Innovative approaches are needed to address barriers to couple's testing and increase uptake of HIV testing. Using qualitative data collection methods, a formative study was conducted to assess the acceptability of a home-based couples counseling and testing (HBCCT) approach. Eligible study participants included married men and women, HIV-infected individuals, health care and home-based care providers, voluntary counseling and testing counselors, and community leaders. A total of 91 individuals participated in focus group discussions (FGDs) and in-depth interviews conducted between September 2009 and January 2010 in rural settings in Northern Tanzania. An HBCCT intervention appears to be broadly acceptable among participants. Benefits of HBCCT were identified in terms of access, confidentiality, and strengthening the relationship. Fears of negative consequences from knowing one's HIV status, including stigma, blame, physical abuse, or divorce, remain a concern and a potential barrier to the successful provision of the intervention. Lessons for implementation highlighted the importance of appointments for home visits, building relationships of confidence and trust between counselors and clients, and assessing and responding to a couple's readiness to undergo HIV testing. HBCCT should addresses HIV stigma, emphasize confidentiality, and improve communication skills for disclosure and decision-making among couples.}, Language = {eng}, Doi = {10.1080/09540121.2011.608796}, Key = {fds254053} } @article{fds254007, Author = {Adams, JL and Almond, MLG and Ringo, EJ and Shangali, WH and Sikkema, KJ}, Title = {Feasibility of nurse-led antidepressant medication management of depression in an HIV clinic in Tanzania.}, Journal = {International Journal of Psychiatry in Medicine}, Volume = {43}, Number = {2}, Pages = {105-117}, Year = {2012}, ISSN = {0091-2174}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22849034}, Keywords = {Adult • Ambulatory Care Facilities • Amitriptyline • Anti-Retroviral Agents • Antidepressive Agents, Tricyclic • Comorbidity • Depressive Disorder* • Disease Management • Feasibility Studies • Female • Follow-Up Studies • HIV • HIV Infections* • Humans • Male • Nurses • Primary Health Care • Tanzania • Treatment Outcome • administration & dosage* • diagnosis • drug therapy • epidemiology • organization & administration*}, Abstract = {OBJECTIVE: Sub-Saharan Africa has the highest HIV prevalence worldwide and depression is highly prevalent among those infected. The negative impact of depression on HIV outcomes highlights the need to identify and treat it in this population. A model for doing this in lower-resourced settings involves task-shifting depression treatment to primary care; however, HIV-infected individuals are often treated in a parallel HIV specialty setting. We adapted a model of task-shifting, measurement-based care (MBC), for an HIV clinic setting and tested its feasibility in Tanzania. MBC involves measuring depressive symptoms at meaningful intervals and adjusting antidepressant medication treatment based on the measure of illness. METHOD: Twenty adults presenting for care at an outpatient HIV clinic in Tanzania were enrolled and followed by a nurse care manager who measured depressive symptoms at baseline and every 4 weeks for 12 weeks. An algorithm-based decision-support tool was utilized by the care manager to recommend individualized antidepressant medication doses to participants' HIV providers at each visit. RESULTS: Retention was high and fidelity of the care manager to the MBC protocol was exceptional. Follow through of antidepressant prescription dosing recommendations by the prescriber was low. Limited availability of antidepressants was also noted. Despite challenges, baseline depression scores decreased over the 12-week period. CONCLUSIONS: Overall, the model of algorithm-based nursing support of prescription decisions was feasible. Future studies should address implementation issues of medication supply and dosing. Further task-shifting to relatively more abundant and lower-skilled health workers, such as nurses' aides, warrants examination.}, Language = {eng}, Doi = {10.2190/PM.43.2.a}, Key = {fds254007} } @misc{fds254039, Author = {Otwombe, KN and Sikkema, KJ and Dietrich, J and de Bruyn, G and van der Watt, M and Gray, GE}, Title = {Willingness to participate in biomedical HIV prevention studies after the HVTN 503/Phambili trial: a survey conducted among adolescents in Soweto, South Africa.}, Journal = {Journal of Acquired Immune Deficiency Syndromes}, Volume = {58}, Number = {2}, Pages = {211-218}, Year = {2011}, Month = {October}, ISSN = {1944-7884}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21765362}, Keywords = {AIDS Vaccines* • Adolescent • Clinical Trials as Topic • Cross-Sectional Studies • Female • HIV Infections • Humans • Life Change Events • Logistic Models • Male • Patient Participation • Self Efficacy • Sex Factors • Sexual Behavior • Sexual Partners • South Africa • prevention & control* • psychology • psychology*}, Abstract = {Adolescents may be appropriate for inclusion in biomedical HIV prevention trials. Adolescents' overall willingness to participate (WTP) in biomedical HIV prevention trials was examined, including after the prematurely discontinued phase IIb HVTN 503/Phambili HIV vaccine trial, in Soweto, South Africa.An interview-administered cross-sectional survey was conducted among 506 adolescents (16-18 years) between October 2008 and March 2009. The assessment included WTP in HIV prevention trials, sexual and substance use behavior, and related psychosocial constructs. Multivariate logistic regression analyses examined predictors of WTP in biomedical prevention trials.The sample primarily consisted of female participants (n = 298, 59%), and 50% of all participants were sexually active. WTP in general was high (93%), with 75% WTP in a vaccine trial after being informed about the HVTN 503/Phambili trial. Less exposure to stressors [odds ratio (OR): 2.8, confidence interval (CI): 1.3 to 6.3] was associated with adolescents' WTP in HIV biomedical prevention trials overall. Those with less exposure to stressors (OR: 1.7, CI: 1.1 to 2.8) and not sexually active (OR: 2.1, CI: 1.4 to 3.3) were predictive of WTP after the HVTN 503/Phambili trial. A higher number of sexual partners were associated with unwillingness to participate more generally (P = 0.039) and specifically after the HIV vaccine trial (P = 0.0004).The high level of adolescents' WTP in biomedical prevention trials is encouraging, especially after the prematurely discontinued HVTN 503/Phambili HIV vaccine trial. High-risk youth were less likely to be WTP, although those not yet sexually active were more WTP. Future biomedical HIV prevention trials should address challenges to enrollment of high-risk adolescents who may show less WTP.}, Language = {eng}, Doi = {10.1097/qai.0b013e31822b7702}, Key = {fds254039} } @article{fds253968, Author = {Dietrich, J and Khunwane, M and Laher, F and de Bruyn, G and Sikkema, KJ and Gray, G}, Title = {"Group sex" parties and other risk patterns: A qualitative study about the perceptions of sexual behaviors and attitudes of adolescents in Soweto, South Africa.}, Journal = {Vulnerable Children and Youth Studies}, Volume = {6}, Number = {3}, Pages = {244-254}, Year = {2011}, Month = {September}, ISSN = {1745-0128}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22844344}, Keywords = {Adult • Ambulatory Care Facilities • Amitriptyline • Anti-Retroviral Agents • Antidepressive Agents, Tricyclic • Comorbidity • Depressive Disorder* • Disease Management • Feasibility Studies • Female • Follow-Up Studies • HIV • HIV Infections* • Humans • Male • Nurses • Primary Health Care • Tanzania • Treatment Outcome • administration & dosage* • diagnosis • drug therapy • epidemiology • organization & administration*}, Abstract = {This study explored perceptions about sexual behaviors and attitudes of adolescents living in Soweto, Johannesburg, South Africa, from the perspective of parents, counselors and adolescents. A qualitative methodology was applied. Nine focus group discussions (FGDs) were held; three with parents of adolescents, two with counselors who work with adolescents, two with female adolescents aged 16-18 years and two with male adolescents aged 16-18 years. In total, 80 participants were recruited from in and around Soweto. FGDs were guided by a semi-structured interview guide, audio-recorded, transcribed verbatim and translated into English. Data were analyzed using Maxqda, a qualitative software analysis program. There were eight key themes related to adolescent sexuality and perceived attitudes towards relationships. Five themes were common to all participant groupings (parents, counselors and adolescents): (1) dating during adolescence, (2) adolescent females dating older males, (3) condom use amongst adolescents, (4) pregnancy and (5) homosexuality. (6) Sex as a regular and important activity among adolescents and (7) group sex practices among adolescents emerged as themes from adolescent and counselor FGDs. Lastly, (8) the role of the media as an influence on adolescent sexuality was common to adolescent and parent groups. Risky sexual behaviors continue among adolescents, with group sex parties a concerning emergent phenomenon that necessitates further study. HIV, other STIs and pregnancy prevention interventions should address multiple levels of influence to address context-specific influences.}, Language = {ENG}, Doi = {10.1080/17450128.2011.597796}, Key = {fds253968} } @article{fds254040, Author = {Sikkema, KJ and Hansen, NB and Kochman, A and Santos, J and Watt, MH and Wilson, PA and Delorenzo, A and Laudato, J and Mayer, G}, Title = {THE DEVELOPMENT AND FEASIBILITY OF A BRIEF RISK REDUCTION INTERVENTION FOR NEWLY HIV-DIAGNOSED MEN WHO HAVE SEX WITH MEN.}, Journal = {Journal of Community Psychology}, Volume = {39}, Number = {6}, Pages = {717-732}, Year = {2011}, Month = {August}, ISSN = {0090-4392}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22228917}, Keywords = {Adolescent • Adult • Alcohol Drinking* • Choice Behavior • Female • HIV Infections • Humans • Interpersonal Relations • Male • Middle Aged • Risk-Taking • Sexual Behavior* • South Africa • Young Adult • prevention & control}, Abstract = {Men who have sex with men (MSM) represent more than half of all new HIV infections in the United States. Utilizing a collaborative, community based approach, a brief risk reduction intervention was developed and pilot tested among newly HIV-diagnosed MSM receiving HIV care in a primary care setting. Sixty-five men, within 3 months of diagnosis, were randomly assigned to the experimental condition or control condition and assessed at baseline, 3-month, and 6-month follow-up. Effect sizes were calculated to explore differences between conditions and over time. Results demonstrated the potential effectiveness of the intervention in reducing risk behavior, improving mental health, and increasing use of ancillary services. Process evaluation data demonstrated the acceptability of the intervention to patients, clinic staff, and administration. The results provide evidence that a brief intervention can be successfully integrated into HIV care services for newly diagnosed MSM and should be evaluated for efficacy.}, Language = {ENG}, Doi = {10.1002/jcop.20463}, Key = {fds254040} } @article{fds254046, Author = {Puffer, ES and Meade, CS and Drabkin, AS and Broverman, SA and Ogwang-Odhiambo, RA and Sikkema, KJ}, Title = {Individual- and family-level psychosocial correlates of HIV risk behavior among youth in rural Kenya.}, Journal = {Aids Behav}, Volume = {15}, Number = {6}, Pages = {1264-1274}, Year = {2011}, Month = {August}, ISSN = {1573-3254}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20945157}, Keywords = {Adolescent • Adolescent Behavior* • Caregivers • Child • Cross-Sectional Studies • Female • HIV Infections • Health Knowledge, Attitudes, Practice* • Humans • Kenya • Male • Questionnaires • Risk Factors • Risk-Taking • Rural Population • Sexual Behavior • Sexual Partners • Social Support • prevention & control* • psychology* • transmission}, Abstract = {Associations between individual- and family-level psychosocial factors and sexual behavior were examined among 325 adolescents ages 10-18 in rural Kenya. History of sexual activity was reported by 51% of males and 30% of females. Among those reporting sex within the past year, 64% of males and 32% of females had multiple partners; 85% of males and 54% of females reported not using a condom at last sex. Multivariate logistic regression modeling demonstrated sexually active adolescents were significantly more likely to be older, male, more accepting of risky behavior, and have greater perceived HIV risk, caregiver social support, social support related to HIV, and emotional problems. Youths reporting high-risk behavior (unprotected sex or multiple partners) were significantly more likely to be younger, male, and have lower sex-related self-efficacy, lower caregiver monitoring, and more externalizing problems. Future studies should evaluate HIV prevention interventions targeting improvements in mental health and family relationships.}, Language = {eng}, Doi = {10.1007/s10461-010-9823-8}, Key = {fds254046} } @article{fds254049, Author = {Adams, JL and Hansen, NB and Fox, AM and Taylor, BB and van Rensburg, MJ and Mohlahlane, R and Sikkema, KJ}, Title = {Correlates of HIV testing among abused women in South Africa.}, Journal = {Violence Against Women}, Volume = {17}, Number = {8}, Pages = {1014-1023}, Year = {2011}, Month = {August}, ISSN = {1552-8448}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21727154}, Keywords = {Adult • Battered Women • Child • Child Care • Female • HIV • HIV Infections • HIV Seropositivity • Health Services Accessibility* • Humans • Interviews as Topic • Male • Mass Screening* • Middle Aged • Odds Ratio • Organizations • Patient Acceptance of Health Care* • Police • Prevalence • Rape* • Sexual Partners • South Africa • Spouse Abuse* • Women's Health Services • Young Adult • diagnosis • diagnosis* • epidemiology • prevention & control* • virology}, Abstract = {Gender-based violence increases a woman's risk for HIV but little is known about her decision to get tested. We interviewed 97 women seeking abuse-related services from a nongovernmental organization (NGO) in Johannesburg, South Africa. Forty-six women (47%) had been tested for HIV. Caring for children (odds ratio [OR] = 0.27, 95% confidence interval [CI] = [0.07, 1.00]) and conversing with partner about HIV (OR = 0.13, 95% CI = [0.02, 0.85]) decreased odds of testing. Stronger risk-reduction intentions (OR = 1.27, 95% CI = [1.01, 1.60]) and seeking help from police (OR = 5.51, 95% CI = [1.18, 25.76]) increased odds of testing. Providing safe access to integrated services and testing may increase testing in this population. Infection with HIV is highly prevalent in South Africa where an estimated 16.2% of adults between the ages of 15 and 49 have the virus. The necessary first step to stemming the spread of HIV and receiving life-saving treatment is learning one's HIV serostatus through testing. Many factors may contribute to someone's risk of HIV infection and many barriers may prevent testing. One factor that does both is gender-based violence.}, Language = {eng}, Doi = {10.1177/1077801211414166}, Key = {fds254049} } @misc{fds254051, Author = {Mundell, JP and Visser, MJ and Makin, JD and Kershaw, TS and Forsyth, BWC and Jeffery, B and Sikkema, KJ}, Title = {The impact of structured support groups for pregnant South African women recently diagnosed HIV positive.}, Journal = {Women & Health}, Volume = {51}, Number = {6}, Pages = {546-565}, Year = {2011}, Month = {August}, ISSN = {1541-0331}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21973110}, Keywords = {Adaptation, Psychological* • Adult • Avoidance Learning • Case-Control Studies • Female • Follow-Up Studies • HIV Seropositivity • Health Resources • Humans • Poverty • Pregnancy • Pregnancy Complications, Infectious • Regression Analysis • Self Concept* • Self Disclosure* • Self-Help Groups* • Social Support* • South Africa • Young Adult • psychology*}, Abstract = {The authors of this study evaluated a structured 10-session psychosocial support group intervention for newly HIV-diagnosed pregnant South African women. Participants were expected to display increases in HIV disclosure, self-esteem, active coping and positive social support, and decreases in depression, avoidant coping, and negative social support. Three hundred sixty-one pregnant HIV-infected women were recruited from four antenatal clinics in Tshwane townships from April 2005 to September 2006. Using a quasi-experimental design, assessments were conducted at baseline and two and eight months post-intervention. A series of random effects regression analyses were conducted, with the three assessment points treated as a random effect of time. At both follow-ups, the rate of disclosure in the intervention group was significantly higher than that of the comparison group (p<0.001). Compared to the comparison group at the first follow-up, the intervention group displayed higher levels of active coping (t=2.68, p<0.05) and lower levels of avoidant coping (t=-2.02, p<0.05), and those who attended at least half of the intervention sessions exhibited improved self-esteem (t=2.11, p<0.05). Group interventions tailored for newly HIV positive pregnant women, implemented in resource-limited settings, may accelerate the process of adjusting to one's HIV status, but may not have sustainable benefits over time.}, Language = {eng}, Doi = {10.1080/03630242.2011.606356}, Key = {fds254051} } @misc{fds254038, Author = {Sikkema, KJ and Watt, MH and Meade, CS and Ranby, KW and Kalichman, SC and Skinner, D and Pieterse, D}, Title = {Mental health and HIV sexual risk behavior among patrons of alcohol serving venues in Cape Town, South Africa.}, Journal = {J Acquir Immune Defic Syndr}, Volume = {57}, Number = {3}, Pages = {230-237}, Year = {2011}, Month = {July}, ISSN = {1944-7884}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21372724}, Keywords = {Adolescent • Adult • Aged • Alcohol Drinking* • Depression • Female • HIV Infections • Humans • Logistic Models • Male • Mental Health* • Middle Aged • Risk-Taking* • Sexual Behavior* • South Africa • Stress Disorders, Post-Traumatic • Substance-Related Disorders • Young Adult • complications • epidemiology • epidemiology* • prevention & control • psychology}, Abstract = {BACKGROUND: Alcohol-serving venues in South Africa provide a location for HIV prevention interventions due to risk factors of patrons in these establishments. Understanding the association between mental health and risk behaviors in these settings may inform interventions that address alcohol use and HIV prevention. METHODS: Participants (n = 738) were surveyed in 6 alcohol-serving venues in Cape Town to assess post-traumatic stress disorder (PTSD) and depression symptoms, traumatic experiences, sexual behavior, and substance use. Logistic regression models examined whether traumatic experiences predicted PTSD and depression. Generalized linear models examined whether substance use, PTSD, and depressive symptoms predicted unprotected sexual intercourse. Men and women were analyzed separately. RESULTS: Participants exhibited high rates of traumatic experiences, PTSD, depression, alcohol consumption, and HIV risk behaviors. For men, PTSD was associated with being hit by a sex partner, physical child abuse, sexual child abuse and HIV diagnosis; depression was associated with being hit by a sex partner, forced sex and physical child abuse. For women, both PTSD and depression were associated with being hit by a sex partner, forced sex, and physical child abuse. Unprotected sexual intercourse was associated with age, frequency and quantity of alcohol use, drug use, and PTSD for men and frequency and quantity of alcohol use, depression, and PTSD for women. CONCLUSION: Mental health in this setting was poor and was associated with sexual risk behavior. Treating mental health and substance-use problems may aid in reducing HIV infection. Sexual assault prevention and treatment after sexual assault may strengthen HIV prevention efforts.}, Language = {eng}, Doi = {10.1097/QAI.0b013e3182167e7a}, Key = {fds254038} } @article{fds254048, Author = {Adams, J and Pollard, RS and Sikkema, KJ}, Title = {Feasibility of integrated depression care in an HIV clinic.}, Journal = {Psychiatr Serv}, Volume = {62}, Number = {7}, Pages = {804}, Year = {2011}, Month = {July}, ISSN = {1557-9700}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21724798}, Keywords = {Adult • Delivery of Health Care, Integrated* • Depression • Feasibility Studies • Female • HIV Infections* • Humans • Male • Middle Aged • North Carolina • Patient Compliance* • Questionnaires • drug therapy • therapy*}, Abstract = {Gender-based violence increases a woman's risk for HIV but little is known about her decision to get tested. We interviewed 97 women seeking abuse-related services from a nongovernmental organization (NGO) in Johannesburg, South Africa. Forty-six women (47%) had been tested for HIV. Caring for children (odds ratio [OR] = 0.27, 95% confidence interval [CI] = [0.07, 1.00]) and conversing with partner about HIV (OR = 0.13, 95% CI = [0.02, 0.85]) decreased odds of testing. Stronger risk-reduction intentions (OR = 1.27, 95% CI = [1.01, 1.60]) and seeking help from police (OR = 5.51, 95% CI = [1.18, 25.76]) increased odds of testing. Providing safe access to integrated services and testing may increase testing in this population. Infection with HIV is highly prevalent in South Africa where an estimated 16.2% of adults between the ages of 15 and 49 have the virus. The necessary first step to stemming the spread of HIV and receiving life-saving treatment is learning one's HIV serostatus through testing. Many factors may contribute to someone's risk of HIV infection and many barriers may prevent testing. One factor that does both is gender-based violence.}, Language = {eng}, Doi = {10.1176/ps.62.7.pss6207_0804}, Key = {fds254048} } @article{fds254045, Author = {Heckman, TG and Sikkema, KJ and Hansen, N and Kochman, A and Heh, V and Neufeld, S and AIDS and Aging Research Group}, Title = {A randomized clinical trial of a coping improvement group intervention for HIV-infected older adults.}, Journal = {Journal of Behavioral Medicine}, Volume = {34}, Number = {2}, Pages = {102-111}, Year = {2011}, Month = {April}, ISSN = {1573-3521}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20857188}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological* • Aged • Depression • Female • Geriatric Assessment • HIV Infections • Humans • Male • Middle Aged • Psychotherapy • Psychotherapy, Group • Self-Help Groups • Severity of Illness Index • complications • diagnosis • methods* • psychology* • statistics & numerical data* • therapy • therapy*}, Abstract = {This research tested if a 12-session coping improvement group intervention (n = 104) reduced depressive symptoms in HIV-infected older adults compared to an interpersonal support group intervention (n = 105) and an individual therapy upon request (ITUR) control condition (n = 86). Participants were 295 HIV-infected men and women 50-plus years of age living in New York City, Cincinnati, OH, and Columbus, OH. Using A-CASI assessment methodology, participants provided data on their depressive symptoms using the Geriatric Depression Screening Scale (GDS) at pre-intervention, post-intervention, and 4- and 8-month follow-up. Whether conducted with all participants (N = 295) or only a subset of participants diagnosed with mild, moderate, or severe depressive symptoms (N = 171), mixed models analyses of repeated measures found that both coping improvement and interpersonal support group intervention participants reported fewer depressive symptoms than ITUR controls at post-intervention, 4-month follow-up, and 8-month follow-up. The effect sizes of the differences between the two active interventions and the control group were greater when outcome analyses were limited to those participants with mild, moderate, or severe depressive symptoms. At no assessment period did coping improvement and interpersonal support group intervention participants differ in depressive symptoms.}, Language = {eng}, Doi = {10.1007/s10865-010-9292-6}, Key = {fds254045} } @article{fds254005, Author = {Eloff, I and Forsyth, B and Finestone, M and Ebersöhn, L and Visser, M and Ferreira, R and Boeving, A and Sikkema, K}, Title = {Intervention groups for HIV-infected women: The need for additional services}, Journal = {South African Journal of Psychology}, Volume = {41}, Number = {1}, Pages = {38-51}, Publisher = {SAGE Publications}, Year = {2011}, Month = {January}, ISSN = {0081-2463}, url = {http://dx.doi.org/10.1177/008124631104100105}, Abstract = {The Kgolo Mmogo study is a randomised controlled intervention trial that examines the effectiveness of a group intervention to enhance resilience in HIV-infected South African mothers (N = 427) and their young children (N=435). We describe here how the severity of psychological and social problems experienced by some of the study participants required referrals for other services and discuss the barriers encountered in facilitating such referrals. Over a 30-month period 54 mothers and 59 children were referred for additional support. For mothers, the most frequent reasons for referral related to domestic violence and problems within relationships, while for children the most common grounds for referral were the evaluation and treatment of behavioural problems and severe emotional disturbances, including depression. Eight children were referred for suspected abuse. Observations from the study demonstrate that current systems for referral are overloaded and that there is a paucity of specialised services available. Our experience suggests that participants may benefit from using the intervention as a first point of support and that psychosocial referrals should perhaps be delayed until functional advice is provided (within the group) on ways of accessing wider support effectively. The intervention may also benefit from the inclusion of an intervention team member who is specifically tasked to follow up on referrals. This includes follow-up for participants who were not included in the group intervention. Furthermore, we argue that socio-economic constraints which often manifest as lack of mobility to access service delivery, can severely impact on the impiementation of an intervention study in a developing context. This constraint is experienced in terms of limited access to experimental intervention groups and services from referrals. © Psychological Society of South Africa. All rights reserved.}, Doi = {10.1177/008124631104100105}, Key = {fds254005} } @article{fds254047, Author = {Puffer, ES and Kochman, A and Hansen, NB and Sikkema, KJ}, Title = {An evidence-based group coping intervention for women living with HIV and history of childhood sexual abuse.}, Journal = {International Journal of Group Psychotherapy}, Volume = {61}, Number = {1}, Pages = {98-126}, Year = {2011}, Month = {January}, ISSN = {1943-2836}, url = {http://www.ncbi.nlm.nih.gov/pubmed/21244204}, Keywords = {Adaptation, Psychological* • Adult • Child • Child Abuse, Sexual • Cognitive Therapy* • Female • HIV Infections • Humans • Middle Aged • Psychotherapy, Group* • Risk-Taking* • Stress, Psychological • Treatment Outcome • Women • methods • psychology • psychology* • therapy}, Abstract = {Women living with HIV/AIDS and a history of childhood sexual abuse often exhibit sexual trauma symptoms and elevated rates of HIV-risk behaviors. In this paper, we describe a coping skills group intervention that reduced traumatic stress and sexual-risk behavior in a recent randomized clinical trial. We focused on clinical issues that emerged among female participants receiving the intervention. Clinical observations showed that recognizing connections between trauma, psychological distress, and high risk behaviors was a new and powerful experience for many participants. Participants successfully applied psychoeducational material, expressing an increased sense of power and control over their relationships and behaviors as they developed more adaptive cognitive and behavioral skills. Women expressed high levels of satisfaction with the intervention. Recommendations for clinical practice are provided.}, Language = {eng}, Doi = {10.1521/ijgp.2011.61.1.98}, Key = {fds254047} } @article{fds254044, Author = {Meade, CS and Drabkin, AS and Hansen, NB and Wilson, PA and Kochman, A and Sikkema, KJ}, Title = {Reductions in alcohol and cocaine use following a group coping intervention for HIV-positive adults with childhood sexual abuse histories.}, Journal = {Addiction}, Volume = {105}, Number = {11}, Pages = {1942-1951}, Year = {2010}, Month = {November}, ISSN = {1360-0443}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20840176}, Keywords = {Adaptation, Psychological* • Adolescent • Adult • Alcohol Drinking • Child • Child Abuse, Sexual • Cocaine-Related Disorders • Female • HIV Infections • Humans • Intention to Treat Analysis • Linear Models • Logistic Models • Male • New York City • Outcome Assessment (Health Care) • Psychotherapy, Group* • Sexual Behavior • Stress, Psychological • Substance-Related Disorders • Treatment Outcome • Urban Population • complications • epidemiology • psychology • psychology* • rehabilitation • rehabilitation* • statistics & numerical data • therapy • trends}, Abstract = {AIMS: Few interventions exist to reduce alcohol and non-injection drug use among people living with HIV/AIDS. This study tested the effects of a coping group intervention for HIV-positive adults with childhood sexual abuse histories on alcohol, cocaine and marijuana use. DESIGN: Participants were assigned randomly to the experimental coping group or a time-matched comparison support group. Both interventions were delivered in a group format over 15 weekly 90-minute sessions. SETTING AND PARTICIPANTS: A diverse sample of 247 HIV-positive men and women with childhood sexual abuse were recruited from AIDS service organizations and community health centers in New York City. MEASUREMENTS: Substance use was assessed pre- and post-intervention and every 4 months during a 12-month follow-up period. Using an intent-to-treat analysis, longitudinal changes in substance use by condition were assessed using generalized estimating equations. FINDINGS: At baseline, 42% of participants drank alcohol, 26% used cocaine and 26% used marijuana. Relative to participants in the support group, those in the coping group had greater reductions in quantity of alcohol use (Wald χ²(₄)=10.77, P = 0.029) and any cocaine use (Wald χ²(₄) = 9.81, P = 0.044) overtime. CONCLUSIONS: Many HIV patients, particularly those with childhood sexual abuse histories, continue to abuse substances. This group intervention that addressed coping with HIV and sexual trauma was effective in reducing alcohol and cocaine use, with effects sustained at 12-month follow-up. Integrating mental health treatment into HIV prevention may improve outcomes.}, Language = {eng}, Doi = {10.1111/j.1360-0443.2010.03075.x}, Key = {fds254044} } @article{fds254004, Author = {Sikkema, KJ and Wilson, PD and Hansen, NB}, Title = {Erratum: Effects of a coping intervention on transmission risk behavior among people living with HIV/AIDS and a history of childhood sexual abuse (Journal of Acquired Immune Deficiency Syndromes (2008) 47 (506-513))}, Journal = {Journal of Acquired Immune Deficiency Syndromes}, Volume = {55}, Number = {2}, Pages = {286}, Publisher = {Ovid Technologies (Wolters Kluwer Health)}, Year = {2010}, Month = {October}, ISSN = {1525-4135}, url = {http://dx.doi.org/10.1097/QAI.0b013e3181fb43bf}, Doi = {10.1097/QAI.0b013e3181fb43bf}, Key = {fds254004} } @article{fds254043, Author = {Persons, E and Kershaw, T and Sikkema, KJ and Hansen, NB}, Title = {The impact of shame on health-related quality of life among HIV-positive adults with a history of childhood sexual abuse.}, Journal = {Aids Patient Care and Stds}, Volume = {24}, Number = {9}, Pages = {571-580}, Year = {2010}, Month = {September}, ISSN = {1557-7449}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20718687}, Keywords = {Child • Child Abuse, Sexual • Female • HIV Infections • Health Status Indicators • Humans • Male • Quality of Life* • Shame* • Social Support • psychology*}, Abstract = {Childhood sexual abuse is prevalent among people living with HIV, and the experience of shame is a common consequence of childhood sexual abuse and HIV infection. This study examined the role of shame in health-related quality of life among HIV-positive adults who have experienced childhood sexual abuse. Data from 247 HIV-infected adults with a history of childhood sexual abuse were analyzed. Hierarchical linear regression was conducted to assess the impact of shame regarding both sexual abuse and HIV infection, while controlling for demographic, clinical, and psychosocial factors. In bivariate analyses, shame regarding sexual abuse and HIV infection were each negatively associated with health-related quality of life and its components (physical well-being, function and global well-being, emotional and social well-being, and cognitive functioning). After controlling for demographic, clinical, and psychosocial factors, HIV-related, but not sexual abuse-related, shame remained a significant predictor of reduced health-related quality of life, explaining up to 10% of the variance in multivariable models for overall health-related quality of life, emotional, function and global, and social well-being and cognitive functioning over and above that of other variables entered into the model. Additionally, HIV symptoms, perceived stress, and perceived availability of social support were associated with health-related quality of life in multivariable models. Shame is an important and modifiable predictor of health-related quality of life in HIV-positive populations, and medical and mental health providers serving HIV-infected populations should be aware of the importance of shame and its impact on the well-being of their patients.}, Language = {eng}, Doi = {10.1089/apc.2009.0209}, Key = {fds254043} } @article{fds253961, Author = {Puffer, ES and Broverman, S and Odhiambo, RO and Sikkema, KJ}, Title = {MENTAL HEALTH FACTORS ASSOCIATED WITH HIV RISK BEHAVIOR AMONG ADOLESCENTS IN RURAL KENYA}, Journal = {Annals of Behavioral Medicine}, Volume = {39}, Pages = {205-205}, Publisher = {SPRINGER}, Year = {2010}, Month = {April}, ISSN = {0883-6612}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000275841700798&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Key = {fds253961} } @article{fds254070, Author = {Sikkema, KJ and Neufeld, SA and Hansen, NB and Mohlahlane, R and Van Rensburg, MJ and Watt, MH and Fox, AM and Crewe, M}, Title = {Integrating HIV prevention into services for abused women in South Africa.}, Journal = {Aids and Behavior}, Volume = {14}, Number = {2}, Pages = {431-439}, Year = {2010}, Month = {April}, ISSN = {1573-3254}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19826941}, Keywords = {Adult • Battered Women* • Feasibility Studies • Female • HIV Infections • Health Education • Health Knowledge, Attitudes, Practice • Humans • Male • Risk Reduction Behavior • Sexual Partners* • South Africa • Spouse Abuse* • Violence* • prevention & control* • transmission}, Abstract = {The relationship between intimate partner violence (IPV) and HIV risk is well documented, but few interventions jointly address these problems. We developed and examined the feasibility of an intervention to reduce HIV risk behaviors among 97 women seeking services for IPV from a community-based NGO in Johannesburg, South Africa. Two versions of the intervention (a 6-session group and a 1-day workshop) were implemented, both focusing on HIV prevention strategies integrated with issues of gender and power imbalance. Attendance was excellent in both intervention groups. Assessments were conducted at baseline, post-intervention and two-month follow-up to demonstrate the feasibility of an intervention trial. Women in both groups reported reductions in HIV misperceptions and trauma symptoms, and increases in HIV knowledge, risk reduction intentions, and condom use self-efficacy. The 6-session group showed greater improvements in HIV knowledge and decreases in HIV misperceptions in comparison to the 1-day workshop. The study demonstrated the feasibility and potential benefit of providing HIV prevention intervention to women seeking assistance for IPV.}, Language = {eng}, Doi = {10.1007/s10461-009-9620-4}, Key = {fds254070} } @misc{fds254071, Author = {Sikkema, KJ and Watt, MH and Drabkin, AS and Meade, CS and Hansen, NB and Pence, BW}, Title = {Mental health treatment to reduce HIV transmission risk behavior: a positive prevention model.}, Journal = {Aids Behav}, Volume = {14}, Number = {2}, Pages = {252-262}, Year = {2010}, Month = {April}, ISSN = {1573-3254}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20013043}, Keywords = {Behavior Therapy • HIV Infections • Humans • Mental Disorders • Mental Health • Models, Biological* • Patient Compliance • Risk-Taking • Sexual Behavior • complications • drug therapy* • epidemiology • prevention & control* • transmission*}, Abstract = {Secondary HIV prevention, or "positive prevention," is concerned with reducing HIV transmission risk behavior and optimizing the health and quality of life of people living with HIV/AIDS (PLWHA). The association between mental health and HIV transmission risk (i.e., sexual risk and poor medication adherence) is well established, although most of this evidence is observational. Further, a number of efficacious mental health treatments are available for PLWHA yet few positive prevention interventions integrate mental health treatment. We propose that mental health treatment, including behavioral and pharmacologic interventions, can lead to reductions in HIV transmission risk behavior and should be a core component of secondary HIV prevention. We present a conceptual model and recommendations to guide future research on the effect of mental health treatment on HIV transmission risk behavior among PLWHA.}, Language = {eng}, Doi = {10.1007/s10461-009-9650-y}, Key = {fds254071} } @article{fds254066, Author = {Steward, WT and Remien, RH and Higgins, JA and Dubrow, R and Pinkerton, SD and Sikkema, KJ and Truong, H-HM and Johnson, MO and Hirsch, J and Brooks, RA and Morin, SF}, Title = {Behavior change following diagnosis with acute/early HIV infection-a move to serosorting with other HIV-infected individuals. The NIMH Multisite Acute HIV Infection Study: III.}, Journal = {Aids and Behavior}, Volume = {13}, Number = {6}, Pages = {1054-1060}, Year = {2009}, Month = {December}, ISSN = {1573-3254}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19504178}, Keywords = {AIDS Serodiagnosis • Adult • Condoms • Evaluation Studies as Topic • Female • HIV • HIV Infections • Health Behavior • Humans • Male • Risk Factors • Risk Reduction Behavior* • United States • Unsafe Sex • Young Adult • diagnosis* • prevention & control • psychology • psychology* • statistics & numerical data • statistics & numerical data* • transmission • utilization*}, Abstract = {Risk reductions behaviors are especially important during acute/early HIV infection, a period of high transmission risk. We examined how sexual behaviors changed following diagnosis of acute/early HIV infection. Twenty-eight individuals completed structured surveys and in-depth interviews shortly after learning of their infection and 2 months later. Quantitative analyses revealed significant changes after diagnosis, including reductions in total partners and decreases in the proportion of unprotected sex acts occurring with uninfected partners (serosorting). Qualitative findings indicated that these changes were motivated by concerns about infecting others. However, participants were less successful at increasing the frequency with which they used condoms. These results suggest that the initial diagnosis with HIV may constitute an important component of interventions to promote risk reduction during the acute/early stages of the disease.}, Language = {eng}, Doi = {10.1007/s10461-009-9582-6}, Key = {fds254066} } @article{fds254067, Author = {Kelly, JA and Morin, SF and Remien, RH and Steward, WT and Higgins, JA and Seal, DW and Dubrow, R and Atkinson, JH and Kerndt, PR and Pinkerton, SD and Mayer, K and Sikkema, KJ}, Title = {Lessons learned about behavioral science and acute/early HIV infection. The NIMH Multisite Acute HIV Infection Study: V.}, Journal = {Aids and Behavior}, Volume = {13}, Number = {6}, Pages = {1068-1074}, Year = {2009}, Month = {December}, ISSN = {1573-3254}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19504179}, Keywords = {Cost-Benefit Analysis • Female • HIV Infections* • HIV-1 • Health Behavior • Health Knowledge, Attitudes, Practice* • Humans • Male • National Institute of Mental Health (U.S.) • Primary Prevention • Program Evaluation • Public Health • Risk Factors • Sexual Behavior* • Socioeconomic Factors • United States • diagnosis • methods* • prevention & control • psychology • transmission}, Abstract = {Acute/early HIV infection is a period of heightened HIV transmission and a window of opportunity for intervention to prevent onward disease transmission. The NIMH Multisite Acute HIV Infection (AHI) Study was an exploratory initiative aimed at determining the feasibility of recruiting persons with AHI into research, assessing their psychosocial and behavioral characteristics, and examining short-term changes in these characteristics. This paper reports on lessons learned in the study, including: (1) the need to establish the cost-effectiveness of AHI testing; (2) challenges to identifying persons with AHI; (3) the need to increase awareness of acute-phase HIV transmission risks; (4) determining the goals of behavioral interventions following AHI diagnosis; and (5) the need for "rapid response" public health systems that can move quickly enough to intervene while persons are still in the AHI stage. There are untapped opportunities for behavioral and medical science collaborations in these areas that could reduce the incidence of HIV infection.}, Language = {eng}, Doi = {10.1007/s10461-009-9579-1}, Key = {fds254067} } @article{fds254068, Author = {Atkinson, JH and Higgins, JA and Vigil, O and Dubrow, R and Remien, RH and Steward, WT and Casey, CY and Sikkema, KJ and Correale, J and Ake, C and McCutchan, JA and Kerndt, PR and Morin, SF and Grant, I}, Title = {Psychiatric context of acute/early HIV infection. The NIMH Multisite Acute HIV Infection Study: IV.}, Journal = {Aids and Behavior}, Volume = {13}, Number = {6}, Pages = {1061-1067}, Year = {2009}, Month = {December}, ISSN = {1573-3254}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19517225}, Keywords = {Adaptation, Psychological • Adult • Anxiety • Depression • Female • HIV Infections • HIV-1 • Humans • Male • Mental Disorders • Middle Aged • Psychiatric Status Rating Scales • Questionnaires • Sexual Behavior • Stress, Psychological • Substance-Related Disorders • United States • diagnosis • epidemiology • isolation & purification • psychology • psychology* • transmission}, Abstract = {Acute/early HIV infection is a period of high risk for HIV transmission. Better understanding of behavioral aspects during this period could improve interventions to limit further transmission. Thirty-four participants with acute/early HIV infection from six US cities were assessed with the Mini International Diagnostic Interview, Beck Depression Inventory II, State-Trait Anxiety Inventory, Brief COPE, and an in-depth interview. Most had a pre-HIV history of alcohol or substance use disorder (85%); a majority (53%) had a history of major depressive or bipolar disorder. However, post-diagnosis coping was predominantly adaptive, with only mild to moderate elevations of anxious or depressive mood. Respondents described challenges managing HIV in tandem with pre-existing substance abuse problems, depression, and anxiety. Integration into medical and community services was associated with adaptive coping. The psychiatric context of acute/early HIV infection may be a precursor to infection, but not necessarily a barrier to intervention to reduce forward transmission of HIV among persons newly infected.}, Language = {eng}, Doi = {10.1007/s10461-009-9585-3}, Key = {fds254068} } @article{fds254069, Author = {Remien, RH and Higgins, JA and Correale, J and Bauermeister, J and Dubrow, R and Bradley, M and Steward, WT and Seal, DW and Sikkema, KJ and Kerndt, PR and Mayer, KH and Truong, H-HM and Casey, CY and Ehrhardt, AA and Morin, SF}, Title = {Lack of understanding of acute HIV infection among newly-infected persons-implications for prevention and public health: The NIMH Multisite Acute HIV Infection Study: II.}, Journal = {Aids and Behavior}, Volume = {13}, Number = {6}, Pages = {1046-1053}, Year = {2009}, Month = {December}, ISSN = {1573-3254}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19533323}, Keywords = {AIDS Serodiagnosis • Acute Disease • Awareness • HIV Infections* • HIV-1 • Health Knowledge, Attitudes, Practice* • Humans • Male • National Institute of Mental Health (U.S.) • Questionnaires • Risk Factors • United States • Young Adult • diagnosis • isolation & purification* • prevention & control • psychology* • transmission}, Abstract = {Acute/early HIV infection is a period of high HIV transmission. Consequently, early detection of HIV infection and targeted HIV prevention could prevent a significant proportion of new transmissions. As part of an NIMH-funded multisite study, we used in-depth interviews to explore understandings of acute HIV infection (AHI) among 34 individuals diagnosed with acute/early HIV infection in six US cities. We found a marked lack of awareness of AHI-related acute retroviral symptoms and a lack of clarity about AHI testing methods. Most participants knew little about the meaning and/or consequences of AHI, particularly that it is a period of elevated infectiousness. Over time and after the acute stage of infection, many participants acquired understanding of AHI from varied sources, including the Internet, HIV-infected friends, and health clinic employees. There is a need to promote targeted education about AHI to reduce the rapid spread of HIV associated with acute/early infection within communities at risk for HIV.}, Language = {eng}, Doi = {10.1007/s10461-009-9581-7}, Key = {fds254069} } @article{fds254002, Author = {Otwombe, K and Dietrich, J and Sikkema, K and de Bruyn, G and Watt, MVD and Gray, G}, Title = {OA04-04. Perceived parental willingness for their adolescents to participate in future HIV prevention trials: A survey conducted amongst adolescents in Soweto}, Journal = {Retrovirology}, Volume = {6}, Number = {SUPPL. 3}, Pages = {O28-O28}, Publisher = {Springer Nature}, Year = {2009}, Month = {October}, ISSN = {1742-4690}, url = {http://dx.doi.org/10.1186/1742-4690-6-S3-O28}, Doi = {10.1186/1742-4690-6-S3-O28}, Key = {fds254002} } @article{fds254003, Author = {Makongoza, N and Dietrich, J and Otwombek, K and De Bruyn and G and Sikkema, K and Gray, G}, Title = {P19-27. Willingness of adolescents in Soweto, South Africa to participate in future HIV prevention trials}, Journal = {Retrovirology}, Volume = {6}, Number = {SUPPL. 3}, Pages = {P347-P347}, Publisher = {Springer Nature}, Year = {2009}, Month = {October}, ISSN = {1742-4690}, url = {http://dx.doi.org/10.1186/1742-4690-6-S3-P347}, Doi = {10.1186/1742-4690-6-S3-P347}, Key = {fds254003} } @article{fds254017, Author = {Beckwith, CG and Cornwall, AH and Dubrow, R and Chapin, K and Ducharme, R and Rodriguez, I and Velasquez, L and Merson, MH and Sikkema, KJ and Mayer, K}, Title = {Identifying acute HIV infection in Rhode Island.}, Journal = {Medicine and Health, Rhode Island}, Volume = {92}, Number = {7}, Pages = {231-233}, Year = {2009}, Month = {July}, ISSN = {1086-5462}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19685637}, Keywords = {AIDS Serodiagnosis • Acute Disease • Adult • Female • HIV Infections • Humans • Male • Mass Screening • Middle Aged • Referral and Consultation • Rhode Island • Unsafe Sex • diagnosis* • epidemiology • prevention & control • statistics & numerical data • transmission}, Abstract = {The relationship between intimate partner violence (IPV) and HIV risk is well documented, but few interventions jointly address these problems. We developed and examined the feasibility of an intervention to reduce HIV risk behaviors among 97 women seeking services for IPV from a community-based NGO in Johannesburg, South Africa. Two versions of the intervention (a 6-session group and a 1-day workshop) were implemented, both focusing on HIV prevention strategies integrated with issues of gender and power imbalance. Attendance was excellent in both intervention groups. Assessments were conducted at baseline, post-intervention and two-month follow-up to demonstrate the feasibility of an intervention trial. Women in both groups reported reductions in HIV misperceptions and trauma symptoms, and increases in HIV knowledge, risk reduction intentions, and condom use self-efficacy. The 6-session group showed greater improvements in HIV knowledge and decreases in HIV misperceptions in comparison to the 1-day workshop. The study demonstrated the feasibility and potential benefit of providing HIV prevention intervention to women seeking assistance for IPV.}, Language = {eng}, Doi = {10.1007/s10461-009-9620-4}, Key = {fds254017} } @article{fds254016, Author = {Dubrow, R and Sikkema, KJ and Mayer, KH and Bruce, RD and Julian, P and Rodriguez, I and Beckwith, C and Roome, A and Dunne, D and Boeving, A and Kidder, TJ and Jenkins, H and Dobson, M and Becker, J and Merson, MH}, Title = {Diagnosis of acute HIV infection in Connecticut.}, Journal = {Connecticut Medicine}, Volume = {73}, Number = {6}, Pages = {325-331}, Year = {2009}, Month = {June}, ISSN = {0010-6178}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19637661}, Keywords = {Adolescent • Adult • Connecticut • Feasibility Studies • HIV Infections • Humans • Middle Aged • Primary Health Care • Risk Factors • Young Adult • diagnosis* • epidemiology • immunology}, Abstract = {Acute HIV infection (AHI) is the earliest stage of HIV disease, when plasma HIV viremia, but not HIV antibodies, can be detected. Acute HIV infection often presents as a nonspecific viral syndrome. However, its diagnosis, which enables linkage to early medical care and limits further HIV transmission, is seldom made. We describe the experience of Yale's Center for Interdisciplinary Research on AIDS with AHI diagnosis in Connecticut, as a participating center in the National Institute of Mental Health Multisite AHI Study. We sought to identify AHI cases by clinical referrals and by screening for AHI at two substance abuse care facilities and an STD clinic. We identified one case by referral and one through screening of 590 persons. Screening for AHI is feasible and probably cost effective. Primary care providers should include AHI in the differential diagnosis when patients present with a nonspecific viral syndrome.}, Language = {eng}, Doi = {10.1007/s10461-009-9620-4}, Key = {fds254016} } @article{fds254065, Author = {Johnson, CJ and Heckman, TG and Hansen, NB and Kochman, A and Sikkema, KJ}, Title = {Adherence to antiretroviral medication in older adults living with HIV/AIDS: a comparison of alternative models.}, Journal = {Aids Care Psychological and Socio Medical Aspects of Aids/Hiv}, Volume = {21}, Number = {5}, Pages = {541-551}, Year = {2009}, Month = {May}, ISSN = {1360-0451}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19444661}, Keywords = {Adaptation, Psychological • Aged • Aged, 80 and over • Anti-HIV Agents • Female • HIV Infections • Humans • Male • Medication Adherence • Middle Aged • Social Support • Stress, Psychological • United States • drug therapy • psychology* • therapeutic use*}, Abstract = {The CDC estimates that by 2015, half of all persons living with HIV/AIDS in the USA will be over the age of 50. Despite increasing HIV seroprevalence rates in older adults, most research examining adherence to antiretroviral therapy (ART) has focused on young HIV-infected persons and, in general, has been atheoretical in nature. This study examined two ART adherence conceptual frameworks to determine whether these models generalize to HIV-seropositive older adults. Two hundred and forty-four HIV-positive adults 50-plus years of age were recruited through AIDS service organizations in Ohio and New York. Participants completed a neuropsychological battery and an audio computer-assisted self-interview. FIML SEM analyses revealed that neuropsychological functioning was not associated with adherence. Fit indices supported a stress and coping model, with negative affect mediating the effects of social support and maladaptive coping on ART adherence. Results were consistent with stress and coping models and suggest that interventions intending to increase adherence to ART in HIV-infected older adults may be more effective if they address negative affect and enhance adaptive coping and social support.}, Language = {eng}, Doi = {10.1080/09540120802385611}, Key = {fds254065} } @article{fds254055, Author = {Hansen, NB and Cavanaugh, CE and Vaughan, EL and Connell, CM and Tate, DC and Sikkema, KJ}, Title = {The influence of personality disorder indication, social support, and grief on alcohol and cocaine use among HIV-positive adults coping with AIDS-related bereavement.}, Journal = {Aids and Behavior}, Volume = {13}, Number = {2}, Pages = {375-384}, Year = {2009}, Month = {April}, ISSN = {1573-3254}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17846878}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological • Adult • Alcohol Drinking • Bereavement* • Cocaine-Related Disorders • Depression • Female • Grief* • HIV Infections • Humans • Male • Personality Disorders • Social Support* • Stress, Psychological • complications • etiology • mortality • psychology • psychology*}, Abstract = {Substance use is prevalent among HIV-positive adults and linked to a number of adverse health consequences; however little is known about risk and protective factors that influence substance use among HIV-positive adults coping with AIDS-related bereavement. Using structural equation modeling (SEM), male gender, diagnostic indications of antisocial and borderline personality disorders (PD), and grief severity were tested as risk factors, and social support as a protective factor, for alcohol and cocaine use among a diverse sample of 268 HIV-positive adults enrolled in an intervention for AIDS-related bereavement. Results indicated that the hypothesized model fit the study data. Male gender, PD indication, and social support had direct effects on substance use. PD had significant indirect effects on both alcohol and cocaine use, mediated by social support, but not by grief. Finally, both PD and social support had significant, but opposite, effects on grief. Implications for intervention and prevention efforts are discussed.}, Language = {eng}, Doi = {10.1007/s10461-007-9308-6}, Key = {fds254055} } @article{fds254057, Author = {Meade, CS and Kershaw, TS and Hansen, NB and Sikkema, KJ}, Title = {Long-term correlates of childhood abuse among adults with severe mental illness: adult victimization, substance abuse, and HIV sexual risk behavior.}, Journal = {Aids Behav}, Volume = {13}, Number = {2}, Pages = {207-216}, Year = {2009}, Month = {April}, ISSN = {1573-3254}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17968646}, Keywords = {Adolescent • Adult • Child • Child Abuse, Sexual • Child, Preschool • Crime Victims* • Female • HIV Infections* • Humans • Male • Mental Disorders • Middle Aged • Models, Theoretical • Questionnaires • Risk Factors • Risk-Taking* • Sexual Behavior* • Substance-Related Disorders • Young Adult • epidemiology • psychology • psychology* • statistics & numerical data • statistics & numerical data*}, Abstract = {The prevalence of childhood sexual and physical abuse among persons with severe mental illness (SMI) is disproportionately high. Adults with SMI also engage in high rates of HIV risk behaviors. This study examined the association between childhood abuse and adult victimization, substance abuse, and lifetime HIV sexual risk in a sample of 152 adults with SMI receiving community mental health services. Structured interviews assessed psychiatric, psychosocial, and behavioral risk factors. Seventy percent reported childhood physical and/or sexual abuse, and 32% reported both types of abuse. Participants with childhood abuse were more likely to report adult victimization and greater HIV risk. A structural equation model found that childhood abuse was directly and indirectly associated with HIV risk through drug abuse and adult vicitimization. Integrated treatment approaches that address interpersonal violence and substance abuse may be necessary for HIV risk reduction in this population.}, Language = {eng}, Doi = {10.1007/s10461-007-9326-4}, Key = {fds254057} } @article{fds254063, Author = {Meade, CS and Hansen, NB and Kochman, A and Sikkema, KJ}, Title = {Utilization of medical treatments and adherence to antiretroviral therapy among HIV-positive adults with histories of childhood sexual abuse.}, Journal = {Aids Patient Care Stds}, Volume = {23}, Number = {4}, Pages = {259-266}, Year = {2009}, Month = {April}, ISSN = {1557-7449}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19260772}, Keywords = {Adult • Ambulatory Care • Anti-HIV Agents • Child • Child Abuse, Sexual* • Emergency Medical Services • Female • HIV Infections • Humans • Male • Middle Aged • Patient Compliance* • Social Support • complications • drug therapy* • psychology • statistics & numerical data • therapeutic use* • therapy • utilization*}, Abstract = {HIV is a chronic, life-threatening illness that necessitates regular and consistent medical care. Childhood sexual abuse (CSA) is a common experience among HIV-positive adults and may interfere with treatment utilization. This study examined rates and correlates of treatment utilization among HIV-positive adults with CSA enrolled in a coping intervention trial in New York City. The baseline assessment included measures of treatment utilization, mental health, substance abuse, and other psychosocial factors. In 2002-2004, participants (50% female, 69% African-American, M = 42.3 +/- 6.8 years old) were recruited. Nearly all (99%) received HIV medical care. However, 20% had no outpatient visits and 24% sought emergency services in the past 4 months. Among 184 participants receiving antiretroviral therapy (ART), 22% were less than 90% adherent in the past week. In a multivariable logistic regression model, no outpatient treatment was associated with African American race (AOR = 3.46 [1.42-8.40]), poor social support (AOR = 1.59 [1.03-2.45]), and abstinence from illicit drug use (AOR = 0.37 [0.16-0.85]). Emergency service utilization was associated with HIV symptoms (AOR = 2.30 [1.22-4.35]), binge drinking (AOR=2.92 (1.18-7.24)), and illicit drug use (AOR = 1.98 [1.02-3.85]). Poor medication adherence was associated with trauma symptoms (AOR = 2.64 [1.07-6.75]) and poor social support (AOR = 1.82 [1.09-2.97]). In sum, while participants had access to HIV medical care, a sizable minority did not adhere to recommended guidelines and thus may not be benefiting optimally from treatment. Interventions targeting HIV-positive adults with CSA histories may need to address trauma symptoms, substance abuse, and poor social support that interfere with medical treatment utilization and adherence.}, Language = {eng}, Doi = {10.1089/apc.2008.0210}, Key = {fds254063} } @article{fds254061, Author = {Smith, NG and Tarakeshwar, N and Hansen, NB and Kochman, A and Sikkema, KJ}, Title = {Coping mediates outcome following a randomized group intervention for HIV-positive bereaved individuals.}, Journal = {Journal of Clinical Psychology}, Volume = {65}, Number = {3}, Pages = {319-335}, Year = {2009}, Month = {March}, ISSN = {1097-4679}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19152338}, Keywords = {Adaptation, Psychological* • Adult • Bereavement* • Female • HIV Seropositivity* • Humans • Male • Middle Aged • New York City • Outcome Assessment (Health Care)* • Psychotherapy, Group* • Questionnaires • Wisconsin • Young Adult}, Abstract = {The purpose of this study was to examine the mechanisms responsible for the beneficial psychological effects of a coping-focused group intervention for HIV-positive individuals who had lost loved ones to AIDS. Data from 235 HIV-positive men and women enrolled in a randomized controlled clinical trial testing a coping-focused group intervention were analyzed using a multiple-indicator-multiple-cause (MIMIC) structural equation model. Results revealed that the effects of the intervention on decreases in depression and grief were mediated by decreases in avoidant coping. Specifically, participants in the intervention condition decreased their use of avoidant coping. Decreases in avoidant coping, in turn, were related to decreased depression and grief. The results of this study help to validate the use of coping-focused interventions for HIV-positive bereaved individuals.}, Language = {eng}, Doi = {10.1002/jclp.20547}, Key = {fds254061} } @article{fds254064, Author = {Hansen, NB and Vaughan, EL and Cavanaugh, CE and Connell, CM and Sikkema, KJ}, Title = {Health-related quality of life in bereaved HIV-positive adults: relationships between HIV symptoms, grief, social support, and Axis II indication.}, Journal = {Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association}, Volume = {28}, Number = {2}, Pages = {249-257}, Year = {2009}, Month = {March}, ISSN = {0278-6133}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19290717}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological • Adult • Antisocial Personality Disorder • Bereavement* • Borderline Personality Disorder • Comorbidity • Female • Grief* • HIV Seropositivity • Homosexuality, Male • Humans • Male • Models, Psychological • Personality Inventory • Psychotherapy, Group • Quality of Life • Sick Role* • Social Support* • Statistics as Topic • epidemiology • psychology • psychology*}, Abstract = {This study evaluated a model of the impact of borderline and antisocial personality disorder indications on HIV symptoms and health-related quality of life (HRQoL) in AIDS-bereaved adults, accounting for grief severity, social support, and years since HIV diagnosis.Structural equation modeling was used to test the proposed model in a sample of 268 HIV-seropositive adults enrolled in an intervention for coping with AIDS-related bereavement.Functional assessment of HIV infection, HIV symptoms.The proposed model demonstrated excellent fit with study data and all hypothesized paths were supported. Personality disorder indication was directly related to HIV symptoms and HRQoL and indirectly related through both social support and grief severity. Social support was negatively related to HIV symptoms and positively related to HRQoL, while grief severity was positively related to HIV symptoms and negatively related to HRQoL. Finally, HIV symptoms had a direct negative relationship with HRQoL.Personality disorders have a direct negative effect on HIV symptoms and HRQoL and indirect effects through grief severity and social support.}, Language = {eng}, Doi = {10.1037/a0013168}, Key = {fds254064} } @article{fds254042, Author = {Sikkema, KJ and Hansen, NB and Meade, CS and Kochman, A and Fox, AM}, Title = {Psychosocial predictors of sexual HIV transmission risk behavior among HIV-positive adults with a sexual abuse history in childhood.}, Journal = {Archives of Sexual Behavior}, Volume = {38}, Number = {1}, Pages = {121-134}, Year = {2009}, Month = {February}, ISSN = {1573-2800}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17999171}, Keywords = {Adaptation, Psychological • Adult • Child Abuse, Sexual • Child, Preschool • Female • HIV Infections • Humans • Logistic Models • Male • Neuropsychological Tests • Odds Ratio • Questionnaires • Risk-Taking* • Shame • Substance-Related Disorders • Unsafe Sex • psychology* • transmission}, Abstract = {Childhood sexual abuse (CSA) is associated with HIV sexual risk behavior. Although many psychosocial correlates of sexual risk among HIV-positive persons have been identified, studies predicting continued risk among HIV-positive adults with histories of CSA are limited. This cross-sectional study identified variables predictive of sexual transmission risk behavior among an ethnically diverse sample of 256 HIV-positive adults (women and men who have sex with men; MSM) with CSA histories. Participants were assessed for trauma symptoms, shame related to HIV and sexual trauma, substance use, coping style, and sexual risk behavior. Logistic regression analyses were conducted to identify variables predictive of unprotected sexual behavior in the past 4 months. Unprotected sex was significantly associated with substance use and trauma-related behavioral difficulties among women and men, and less spiritual coping among men. Unprotected sex with HIV negative or serostatus unknown partners was significantly associated with greater trauma-related behavioral difficulties, more HIV-related shame, and fewer active coping strategies. Thus, trauma symptoms, shame, coping style, and substance use were significantly associated with sexual risk behavior among HIV-positive adults with histories of CSA, with models of prediction differing by gender and partner serostatus. HIV prevention intervention for persons with HIV and CSA histories should address trauma-related behavioral difficulties and enhance coping skills to reduce sexual transmission risk behavior.}, Language = {eng}, Doi = {10.1007/s10508-007-9238-4}, Key = {fds254042} } @article{fds254062, Author = {Visser, MJ and Makin, JD and Vandormael, A and Sikkema, KJ and Forsyth, BWC}, Title = {HIV/AIDS stigma in a South African community.}, Journal = {Aids Care Psychological and Socio Medical Aspects of Aids/Hiv}, Volume = {21}, Number = {2}, Pages = {197-206}, Year = {2009}, Month = {February}, ISSN = {1360-0451}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19229689}, Keywords = {Adolescent • Adult • Aged • Aged, 80 and over • Female • HIV Infections • Health Knowledge, Attitudes, Practice • Humans • Male • Middle Aged • Prejudice* • Public Opinion* • Questionnaires • Socioeconomic Factors • South Africa • Stereotyping* • Young Adult • ethnology • psychology*}, Abstract = {HIV/AIDS-related stigma threatens to undermine interventions to prevent and treat HIV/AIDS. To address stigma in a South African community, a thorough understanding of the nature of stigma in the specific cultural context is needed. The goals of this research were to assess the level of stigmatising attitudes among members of a community, compare this to the level of stigma that is perceived to exist within the community and determine to what extent stigmatising attitudes are affected by socio-demographic characteristics, HIV-related experience and cultural beliefs. A questionnaire was completed by 1077 respondents in key areas in two communities in Tshwane, South Africa. The questionnaire included an assessment of HIV-related experience, HIV-knowledge, personal stigma and perceptions of stigma within the community. The findings indicate that the level of personal stigma was significantly lower than that perceived to be present in the community. Respondents who were more stigmatising were older, male, less educated and less knowledgeable about HIV. They were less likely to know someone with HIV and had more traditional cultural viewpoints. While socio-demographic and cultural factors are difficult to change, efforts aimed at increasing people's knowledge and experience of the epidemic occurring in their community could change the level of stigmatising attitudes within their community. Such efforts could have potential benefits in addressing the epidemic and providing greater support for those with HIV.}, Language = {eng}, Doi = {10.1080/09540120801932157}, Key = {fds254062} } @article{fds253939, Author = {Tarakeshwar, N and Kalichman, SC and Simbayi, LC and Sikkema, KJ}, Title = {HIV prevention needs: Primary prevention and prevention for people living with HIV/AIDS}, Pages = {19-40}, Booktitle = {Public Health Aspects of HIV/AIDS in Low and Middle Income Countries: Epidemiology, Prevention and Care}, Publisher = {Springer New York}, Year = {2008}, Month = {December}, ISBN = {9780387727103}, url = {http://dx.doi.org/10.1007/978-0-387-72711-0_2}, Abstract = {Chapter one of this volume provides an overview of the global scenario of HIV and AIDS. Available data suggests that the number of HIV infections has varied globally since 2000, with HIV rates in some countries such as Kenya and Malawi declining, while other countries such as Uganda and Thailand report setbacks in their previously declining rates of HIV infection. Moreover, HIV/AIDS seems to be gaining further ground in Russia and the most populous regions of the world including India and China. For a sustainable response to the epidemic, both prevention and treatment services need to be brought to scale simultaneously. Although 700,000 people began antiretroviral (ARV) treatment in 2006, around four million people became infected with HIV. As Kevin De Cock, the World Health Organization's (WHO) HIV/AIDS Director emphasized, "We cannot treat our way out of this epidemic. For every case going into treatment, six more are going to the back of the line." (Alcorn, 2007) This chapter provides a broad overview of primary prevention for at-risk populations and prevention interventions targeted to people living with HIV/AIDS. © Springer Science+Business Media, LLC 2008.}, Doi = {10.1007/978-0-387-72711-0_2}, Key = {fds253939} } @article{fds254001, Author = {Chiu, J and Grobbelaar, J and Sikkema, K and Vandormoel, A and Bomela, N and Kershaw, T}, Title = {HIV-related stigma and social capital in South Africa.}, Journal = {Aids Education and Prevention : Official Publication of the International Society for Aids Education}, Volume = {20}, Number = {6}, Pages = {519-530}, Year = {2008}, Month = {December}, ISSN = {0899-9546}, url = {http://dx.doi.org/10.1521/aeap.2008.20.6.519}, Abstract = {Few studies have considered the relationship between social capital and stigmatizing attitudes. The aim of this study is to assess the relationship between HIV stigmatizing attitudes and individual perceptions of social capital in South Africa. The study surveyed 619 community members to assess whether social capital predicted personal and attributed HIV stigmatizing attitudes. Personal stigma was defined as the individual's own attitude toward people with HIV and attributed stigma were those attitudes that the individual perceived as existing in their communities. Results showed that social capital components significantly predicted personal and attributed stigma above and beyond demographic covariates and whether the participant knew someone with HIV. Individual social capital components of empowerment, trust, and group membership related to personal stigma; and safety, trust, and homogeneity of residential area related to attributed stigma.}, Doi = {10.1521/aeap.2008.20.6.519}, Key = {fds254001} } @article{fds254058, Author = {Lovejoy, TI and Heckman, TG and Sikkema, KJ and Hansen, NB and Kochman, A and Suhr, JA and Garske, JP and Johnson, CJ}, Title = {Patterns and correlates of sexual activity and condom use behavior in persons 50-plus years of age living with HIV/AIDS.}, Journal = {Aids and Behavior}, Volume = {12}, Number = {6}, Pages = {943-956}, Year = {2008}, Month = {November}, ISSN = {1573-3254}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18389361}, Keywords = {Bisexuality • Computers • Condoms • Female • HIV Infections • Heterosexuality • Homosexuality, Male • Humans • Interviews as Topic • Male • Middle Aged • New York City • Ohio • Psychology • Questionnaires • Self Disclosure • Sexual Behavior • Sexual Partners • epidemiology • methods • prevention & control* • psychology* • statistics & numerical data* • transmission • utilization*}, Abstract = {This study characterized rates of sexual activity and identified psychosocial and behavioral correlates of sexual activity and condom use in a metropolitan sample of 290 HIV-infected adults 50-plus years of age. Thirty-eight percent of participants were sexually active in the past three months, 33% of whom had at least one occasion of anal or vaginal intercourse that was not condom protected. Rates and correlates of sexual activity and condom use differed between gay/bisexual men, heterosexual men, and heterosexual women. In the past three months, 72% of heterosexual men were sexually active compared to only 36% of gay/bisexual men and 21% of heterosexual women. However, among sexually active persons, only 27% of heterosexual men reported inconsistent condom use compared to 37% of gay/bisexual men and 35% of heterosexual women. As the number of older adults living with HIV/AIDS in the U.S. continues to increase, age-appropriate secondary risk-reduction interventions are urgently needed.}, Language = {eng}, Doi = {10.1007/s10461-008-9384-2}, Key = {fds254058} } @article{fds254060, Author = {Makin, JD and Forsyth, BWC and Visser, MJ and Sikkema, KJ and Neufeld, S and Jeffery, B}, Title = {Factors affecting disclosure in South African HIV-positive pregnant women.}, Journal = {Aids Patient Care and Stds}, Volume = {22}, Number = {11}, Pages = {907-916}, Year = {2008}, Month = {November}, ISSN = {1557-7449}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19025485}, Keywords = {AIDS Serodiagnosis • Demography • Disclosure* • Female • HIV Seropositivity • Humans • Longitudinal Studies • Pregnancy • Pregnancy Complications, Infectious • Psychology • Questionnaires • Risk Factors • Sexual Partners • Socioeconomic Factors • South Africa • psychology* • virology}, Abstract = {To provide understanding of social and psychological factors that affect disclosure of HIV status among women diagnosed HIV-positive in pregnancy, 438 HIV positive women attending antenatal al clinics in Pretoria, South Africa were invited to participate in a longitudinal study. A total of 293 (62%) women were enrolled from June 2003 to December 2004. Questionnaires assessing sociodemographics and psychological measures were administered during pregnancy and at 3 months postdelivery. At enrollment, 59% had disclosed to their partners and 42% to others. This rose to 67% and 59%, respectively, by follow-up. Logistic regression analysis identified being married (adjusted odds Ratio [AOR] 2.32; 95% confidence interval [CI] 1.20-4.47), prior discussion about testing (AOR 4.19; CI 2.34-7.49), having a partner with tertiary education (AOR 2.76; CI 1.29-5.88) and less experience of violence (AOR 0.48; CI 0.24-0.97) as factors associated with having disclosed to partners prior to enrollment. Better housing (AOR 1.26; CI 1.06-1.49), less financial dependence on partners (AOR 0.46; CI 0.25-0.85), and knowing someone with HIV (AOR 2.13; CI 1.20-3.76) were associated with prior disclosure to others. Increased levels of stigma at baseline decreased the likelihood of disclosure to partners postenrollment (AOR 0.91; CI 0.84-0.98) and increased levels of avoidant coping decreased subsequent disclosure to others (AOR 0.84; CI 0.72-0.97). These results provide understanding of disclosure for women diagnosed as HIV positive in pregnancy, and identify variables that could be used to screen for women who require help.}, Language = {eng}, Doi = {10.1089/apc.2007.0194}, Key = {fds254060} } @article{fds254041, Author = {Sikkema, KJ and Wilson, PA and Hansen, NB and Kochman, A and Neufeld, S and Ghebremichael, MS and Kershaw, T}, Title = {Effects of a coping intervention on transmission risk behavior among people living with HIV/AIDS and a history of childhood sexual abuse.}, Journal = {Journal of Acquired Immune Deficiency Syndromes}, Volume = {47}, Number = {4}, Pages = {506-513}, Year = {2008}, Month = {April}, ISSN = {1525-4135}, url = {http://www.ncbi.nlm.nih.gov/pubmed/18176319}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological* • Adult • Child • Child Abuse, Sexual • Female • HIV Infections • Health Education • Humans • Male • Middle Aged • Outcome Assessment (Health Care) • Sexual Behavior • Sexual Partners • methods • prevention & control* • psychology • psychology* • transmission}, Abstract = {To examine the effect of a 15-session coping group intervention compared with a 15-session therapeutic support group intervention among HIV-positive men and women with a history of childhood sexual abuse (CSA) on sexual transmission risk behavior.A randomized controlled behavioral intervention trial with 12-month follow-up.A diverse sample of 247 HIV-positive men and women with histories of CSA was randomized to 1 of 2 time-matched group intervention conditions. Sexual behavior was assessed at baseline; immediately after the intervention; and at 4-, 8-, and 12-month follow-up periods (5 assessments). Changes in frequency of unprotected anal and vaginal intercourse by intervention condition were examined using generalized linear mixed models for all partners, and specifically for HIV-negative or serostatus unknown partners.Participants in the HIV and trauma coping intervention condition decreased their frequency of unprotected sexual intercourse more than participants in the support intervention condition for all partners (P < 0.001; d = 0.38, 0.32, and 0.38 at the 4-, 8-, and 12-month follow-up periods, respectively) and for HIV-negative and serostatus unknown partners (P < 0.001; d = 0.48, 0.39, and 0.04 at the 4-, 8-, and 12-month follow-up periods, respectively).A group intervention to address coping with HIV and CSA can be effective in reducing transmission risk behavior among HIV-positive men and women with histories of sexual trauma.}, Language = {eng}, Doi = {10.1097/qai.0b013e318160d727}, Key = {fds254041} } @article{fds254059, Author = {Wilson, PA and Hansen, NB and Tarakeshwar, N and Neufeld, S and Kochman, A and Sikkema, KJ}, Title = {SCALE DEVELOPMENT OF A MEASURE TO ASSESS COMMUNITY-BASED AND CLINICAL INTERVENTION GROUP ENVIRONMENTS.}, Journal = {Journal of Community Psychology}, Volume = {36}, Number = {3}, Pages = {271-288}, Year = {2008}, Month = {April}, ISSN = {0090-4392}, url = {http://www.ncbi.nlm.nih.gov/pubmed/19018295}, Keywords = {AIDS Serodiagnosis • Demography • Disclosure* • Female • HIV Seropositivity • Humans • Longitudinal Studies • Pregnancy • Pregnancy Complications, Infectious • Psychology • Questionnaires • Risk Factors • Sexual Partners • Socioeconomic Factors • South Africa • psychology* • virology}, Abstract = {Though group interventions are widely used in community-based and clinical settings, there are few brief instruments for assessing the group environment. Two studies on the development of a brief measure to assess intervention group environments are described, and psychometric properties of the new scale are presented. The new measure is based on Moos' (1994) Group Environment Scale (GES). Participants in the studies were from two independent randomized controlled clinical trials (RCTs) of group interventions (combined N = 334). In Study 1 (N = 139), the factor content of the original 90-item GES was examined. The scale was shortened, the response format was changed, and items were adapted and added to in an effort to increase applicability to community-based and clinical intervention groups. In Study 2 (N = 195), the new scale was evaluated, the factor solution obtained in Study 1 was cross-validated, and subsequently the length of the scale was shortened again. The final scale contains 25 items with three subscales. Reliability and validity of the new scale was examined. Finally, the research and practice implications of the scale are discussed.}, Language = {ENG}, Doi = {10.1002/jcop.20193}, Key = {fds254059} } @article{fds253957, Author = {Johnson, CJ and Heckman, TG and Hansen, NB and Sikkema, KJ and Kochman, A}, Title = {Modeling adherence to antiretroviral therapy in HIV-seropositive older adults}, Journal = {Annals of Behavioral Medicine}, Volume = {35}, Pages = {S25-S25}, Publisher = {SPRINGER}, Year = {2008}, Month = {March}, ISSN = {0883-6612}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000259245500095&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Key = {fds253957} } @article{fds253896, Author = {Sikkema, KJ and Kelly, JA and Holtgrave, DR}, Title = {Behavioral interventions for prevention of STDs and HIV infection at the community level}, Pages = {1849-1856}, Booktitle = {Sexually Transmitted Diseases}, Publisher = {The McGraw-Hill Companies}, Editor = {Holmes, KK and et al}, Year = {2008}, Key = {fds253896} } @article{fds253958, Author = {Little, J and Heckman, TG and Sikkema, KJ and Kochman, A and Neufeld, S and Hansen, N}, Title = {AIDS-RELATED SHAME IN OLDER ADULTS LIVING WITH HIV/AIDS}, Journal = {Annals of Behavioral Medicine}, Volume = {33}, Pages = {S60-S60}, Publisher = {SPRINGER}, Year = {2007}, Month = {December}, ISSN = {0883-6612}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000261185300231&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Key = {fds253958} } @article{fds253962, Author = {Lovejoy, T and Heckman, TG and Sikkema, KJ and Kochman, A and Hansen, N and Neufeld, S}, Title = {SEXUAL RISK-TAKING IN PERSONS 50-PLUS YEARS OF AGE LIVING WITH HIV/AIDS}, Journal = {Annals of Behavioral Medicine}, Volume = {33}, Pages = {S179-S179}, Publisher = {OXFORD UNIV PRESS INC}, Year = {2007}, Month = {December}, ISSN = {0883-6612}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000261185300699&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Key = {fds253962} } @article{fds254056, Author = {Masten, J and Kochman, A and Hansen, NB and Sikkema, KJ}, Title = {A short-term group treatment model for gay male survivors of childhood sexual abuse living with HIV/AIDS.}, Journal = {International Journal of Group Psychotherapy}, Volume = {57}, Number = {4}, Pages = {475-496}, Year = {2007}, Month = {October}, ISSN = {0020-7284}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17937509}, Keywords = {Adaptation, Psychological • Adult • Child • Child Abuse, Sexual • HIV Infections • Homosexuality, Male • Humans • Male • Psychotherapy, Group* • Survivors • epidemiology • psychology* • statistics & numerical data}, Abstract = {HIV-positive gay male survivors of childhood sexual abuse (CSA) face three layers of trauma: childhood abuse, homophobic oppression, and HIV/AIDS. Additionally, CSA has been shown to increase HIV risk behavior among gay men, and the trauma of HIV infection often parallels the experience of CSA. Effective coping strategies are particularly important for people living with HIV/AIDS in order to adapt to physical, psychological, and social implications of infection. However, coping strategies once adaptive in the context of CSA may become maladaptive in adulthood. Interventions are needed that enhance coping and address CSA for survivors living with HIV/AIDS to protect their own health and to prevent new transmissions. This article presents a group model found to be efficacious for treating gay male survivors of CSA living with HIV/AIDS.}, Language = {eng}, Doi = {10.1521/ijgp.2007.57.4.475}, Key = {fds254056} } @article{fds254000, Author = {Hansen, N and Kershaw, T and Kochman, A and Sikkema, K}, Title = {A classification and regression trees analysis predicting treatment outcome following a group intervention randomized controlled trial for HIV-positive adult survivors of childhood sexual abuse}, Journal = {Psychotherapy Research}, Volume = {17}, Number = {4}, Pages = {404-415}, Publisher = {Informa UK Limited}, Year = {2007}, Month = {July}, ISSN = {1050-3307}, url = {http://dx.doi.org/10.1080/10503300600953512}, Abstract = {This study demonstrates the utility of classification and regression trees (C&RTs) in predicting treatment outcome. A total of 177 HIV-positive survivors of childhood sexual abuse were randomly assigned to either a 15-session coping group condition or a 15-session support group condition. Six predictive categories were identified using C&RT, three predicting clinically significant improvement and three predicting no change. Variables predicting outcome differed by intervention type; depressive symptoms and active coping strategies predicted outcome for the coping group condition, and shame about sexual abuse and dissociative symptoms predicted outcome for the support group condition. Methodological issues and implications for clinical decision making are discussed.}, Doi = {10.1080/10503300600953512}, Key = {fds254000} } @article{fds254054, Author = {Fox, AM and Jackson, SS and Hansen, NB and Gasa, N and Crewe, M and Sikkema, KJ}, Title = {In their own voices: a qualitative study of women's risk for intimate partner violence and HIV in South Africa.}, Journal = {Violence Against Women}, Volume = {13}, Number = {6}, Pages = {583-602}, Year = {2007}, Month = {June}, ISSN = {1077-8012}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17515407}, Keywords = {Adult • Aggression • Battered Women • Coercion • Cultural Characteristics • Female • HIV Infections • Humans • Interpersonal Relations • Middle Aged • Narration • Questionnaires • Risk Factors • Sexual Partners • Social Environment* • Social Perception • South Africa • Spouse Abuse • Women's Health* • prevention & control • psychology • psychology*}, Abstract = {This study qualitatively examines the intersections of risk for intimate partner violence (IPV) and HIV infection in South Africa. Eighteen women seeking services for relationship violence were asked semistructured questions regarding their abusive experiences and HIV risk. Participants had experienced myriad forms of abuse, which reinforced each other to create a climate that sustained abuse and multiplied HIV risk. Male partners having multiple concurrent sexual relationships, and poor relationship communication compounded female vulnerability to HIV and abuse. A social environment of silence, male power, and economic constraints enabled abuse to continue. "Breaking the silence" and women's empowerment were suggested solutions.}, Language = {eng}, Doi = {10.1177/1077801207299209}, Key = {fds254054} } @article{fds254097, Author = {Tarakeshwar, N and Srikrishnan, AK and Johnson, S and Vasu, C and Solomon, S and Merson, M and Sikkema, K}, Title = {A social cognitive model of health for HIV-positive adults receiving care in India.}, Journal = {Aids and Behavior}, Volume = {11}, Number = {3}, Pages = {491-504}, Year = {2007}, Month = {May}, ISSN = {1090-7165}, url = {http://dx.doi.org/10.1007/s10461-006-9161-z}, Keywords = {Adult • Anti-HIV Agents • Cultural Characteristics* • Family • Female • HIV Infections • Health Services Accessibility • Humans • India • Male • Models, Psychological* • Patient Compliance • Private Sector • Questionnaires • Self Concept • Sexual Behavior • Social Perception* • epidemiology • epidemiology* • organization & administration • organization & administration* • therapeutic use • therapy}, Abstract = {In-depth interviews were conducted with 50 HIV-positive adults (23 women, 27 men) with access to care at a non-governmental organization in Chennai, India to gain a broad understanding of how they managed their HIV infection. Using a Social Cognitive Model of Health, we identified factors within the model's three domains--Personal, Environmental, and Behavioral--that are applicable to this socio-cultural context. The Personal domain's factors were a positive self-concept, family-focused goals, and treatment optimism; the Environmental domain comprised family-based support, treatment availability, access and quality, and HIV stigma and discrimination; and the Behavior domain's factors were medication adherence and health habits, sexual behavior, and social relationships and emotional well-being. Significant differences for many of the factors within the three domains were observed across married men and women, widowed women, unmarried men, and female sex workers. Implications for an enhanced intervention for HIV-infected individuals in similar treatment settings are discussed.}, Language = {eng}, Doi = {10.1007/s10461-006-9161-z}, Key = {fds254097} } @article{fds254083, Author = {Meade, CS and Sikkema, KJ}, Title = {Psychiatric and psychosocial correlates of sexual risk behavior among adults with severe mental illness.}, Journal = {Community Mental Health Journal}, Volume = {43}, Number = {2}, Pages = {153-169}, Year = {2007}, Month = {April}, ISSN = {0010-3853}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17143728}, Keywords = {Acquired Immunodeficiency Syndrome • Adult • Ambulatory Care • Child • Child Abuse, Sexual • Cognitive Therapy • Condoms • Connecticut • Cross-Sectional Studies • Female • HIV Infections • Health Knowledge, Attitudes, Practice • Health Surveys • Humans • Male • Mental Disorders • Middle Aged • Psychotic Disorders • Risk Factors • Sex Factors • Sexual Behavior • Statistics as Topic • Substance-Related Disorders • Unsafe Sex • epidemiology • prevention & control • psychology • psychology* • rehabilitation • statistics & numerical data • transmission* • utilization}, Abstract = {Persons with severe mental illness (SMI) are disproportionately affected by HIV/AIDS. This study examined multivariate correlates of sexual risk among 152 adults with SMI receiving outpatient psychiatric treatment. Structured interviews assessed psychiatric, psychosocial, and behavioral risk factors. The majority was sexually active (65%), and many reported unprotected intercourse (73%), multiple partners (45%), and sex trading (21%) in the past year. Logistic regression models found that sexual behaviors were differentially associated with non-psychotic disorder, psychiatric symptoms, substance abuse, childhood sexual abuse, romantic partnership, and social support (all ps < .05). Findings underscore the need for targeted HIV prevention interventions that address psychiatric and psychosocial risk factors.}, Language = {eng}, Doi = {10.1007/s10597-006-9071-6}, Key = {fds254083} } @article{fds254079, Author = {Sikkema, KJ and Hansen, NB and Kochman, A and Tarakeshwar, N and Neufeld, S and Meade, CS and Fox, AM}, Title = {Outcomes from a group intervention for coping with HIV/AIDS and childhood sexual abuse: reductions in traumatic stress.}, Journal = {Aids and Behavior}, Volume = {11}, Number = {1}, Pages = {49-60}, Year = {2007}, Month = {January}, ISSN = {1090-7165}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16858634}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological* • Adult • Child • Child Abuse, Sexual • Crime Victims* • Female • HIV Infections • Humans • Male • New York City • Psychotherapy, Group* • Stress Disorders, Post-Traumatic • Urban Population • prevention & control • psychology • therapy*}, Abstract = {Childhood sexual abuse is common among HIV-infected persons, though few empirically supported treatments addressing sexual abuse are available for men and women with HIV/AIDS. This study reports the outcome from a randomized controlled trial of a group intervention for coping with HIV and sexual abuse. A diverse sample of 202 HIV-positive men and women who were sexually abused as children was randomly assigned to one of three conditions: a 15-session HIV and trauma coping group intervention, a 15-session support group comparison condition, or a waitlist control (later randomly assigned to an intervention condition). Traumatic stress symptoms were assessed at baseline and post-intervention, with analysis conducted for the three-condition comparison followed by analysis of the two-condition comparison between the coping and support group interventions. Participants in the coping group intervention exhibited reductions in intrusive traumatic stress symptoms compared to the waitlist condition and in avoidant traumatic stress symptoms compared to the support group condition. No differences were found between the support group intervention and waitlist conditions. Tests of clinical significance documented the meaningfulness of change in symptoms.}, Language = {eng}, Doi = {10.1007/s10461-006-9149-8}, Key = {fds254079} } @article{fds332049, Author = {Sikkema, KJ and Meade, CS and Doughty-Berry, JD and Zimmerman, SO and Kloos, B and Snow, DL}, Title = {Community-level HIV prevention for persons with severe mental illness living in supportive housing programs: a pilot intervention study.}, Volume = {33}, Number = {1-2}, Pages = {121-135}, Booktitle = {HIV: Issues with Mental Health and Illness}, Publisher = {The Hawthorne Press, Inc.}, Editor = {Eisenberg, MM and Blank, MB}, Year = {2007}, ISSN = {1085-2352}, url = {http://dx.doi.org/10.1300/J005v33n01_10}, Keywords = {Adult • Cognitive Therapy* • Community Mental Health Services • Connecticut • Female • Group Homes* • HIV Infections • Humans • Male • Mentally Ill Persons • Middle Aged • Outcome Assessment (Health Care)* • Pilot Projects • Preventive Health Services • Program Evaluation • Psychological Tests • Risk Factors • Risk-Taking • Severity of Illness Index • Social Support • Therapeutic Community • organization & administration* • prevention & control* • psychology • psychology* • supply & distribution}, Abstract = {Individuals with severe mental illness (SMI) are at risk for HIV/AIDS. Despite the availability of supportive community programs for those with SMI, there have been no published evaluations of community-level HIV prevention trials among this population. A pilot intervention trial was conducted to determine the feasibility of such an intervention in supportive housing programs (SHPs). A multi-component community-level trial was implemented in two SHPs with a total of 28 residents. Participants completed assessments at three time points: prior to the intervention (baseline), following skills training (post-assessment), and following the 4-month community intervention (follow- up). Results demonstrated significant improvements in psychosocial risk factors at both post- and follow-up assessments, with indications of sexual behavior change at follow-up. The community-level intervention appeared to reduce the risk of HIV among persons with SMI living in SHPs, and supports the importance of conducting larger scale intervention trials.}, Language = {eng}, Doi = {10.1300/J005v33n01_10}, Key = {fds332049} } @article{fds253999, Author = {Ghebremichael, MS and Hansen, NB and Zhang, H and Sikkema, KJ}, Title = {The dose effect of a group intervention for bereaved HIV-positive individuals}, Journal = {Group Dynamics: Theory, Research, and Practice}, Volume = {10}, Number = {3}, Pages = {167-180}, Publisher = {American Psychological Association (APA)}, Year = {2006}, Month = {September}, ISSN = {1089-2699}, url = {http://dx.doi.org/10.1037/1089-2699.10.3.167}, Abstract = {Group interventions for health-related issues such as cancer and HIV infection have demonstrated effectiveness and are widely used, yet the question of dosage for group interventions has received little attention. This study examined the longitudinal effect of varying doses of a group intervention for coping with AIDS-related loss in 158 HIV-positive women and men. Grief and psychiatric distress were assessed at baseline, postintervention, and at 4-, 8-, and 12-month follow-ups. Longitudinal data analyses using mixed models were conducted to examine differences in outcome by dosage. Results show that both grief and psychiatric distress were inversely related to dosage across time, indicating that the higher the intervention exposure, the greater the reduction in distress and grief. The clinical significance of change by dosage was also considered. © 2006 APA, all rights reserved.}, Doi = {10.1037/1089-2699.10.3.167}, Key = {fds253999} } @article{fds254073, Author = {Hansen, NB and Tarakeshwar, N and Ghebremichael, M and Zhang, H and Kochman, A and Sikkema, KJ}, Title = {Longitudinal effects of coping on outcome in a randomized controlled trial of a group intervention for HIV-positive adults with AIDS-related bereavement.}, Journal = {Death Studies}, Volume = {30}, Number = {7}, Pages = {609-636}, Year = {2006}, Month = {September}, ISSN = {0748-1187}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16865824}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological • Adult • Bereavement* • Ethnic Groups • Female • Grief • HIV Seropositivity • Humans • Longitudinal Studies • Male • New York • Psychotherapy, Group* • Quality of Life • Randomized Controlled Trials as Topic • Sexual Behavior • Time Factors • Treatment Outcome • United States • Wisconsin • mortality • psychology • psychology*}, Abstract = {This study examined the longitudinal effects of coping on outcome one year following completion of a randomized, controlled trial of a group coping intervention for AIDS-related bereavement. Bereaved HIV-positive participants (N = 267) were administered measures of grief, psychiatric distress, quality of life, and coping at baseline, post-intervention, and at 4-, 8-, and 12-month follow-ups. Coping strategies directly impacted all outcome variables for both study conditions. Additionally, the coping intervention moderated the relationship between avoidant coping and the longitudinal course of grief and psychiatric distress, resulting in greater reductions in grief and distress for intervention participants after accounting for avoidant coping strategies.}, Language = {eng}, Doi = {10.1080/07481180600776002}, Key = {fds254073} } @article{fds254095, Author = {Sikkema, KJ and Hansen, NB and Ghebremichael, M and Kochman, A and Tarakeshwar, N and Meade, CS and Zhang, H}, Title = {A randomized controlled trial of a coping group intervention for adults with HIV who are AIDS bereaved: longitudinal effects on grief.}, Journal = {Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association}, Volume = {25}, Number = {5}, Pages = {563-570}, Year = {2006}, Month = {September}, ISSN = {0278-6133}, url = {http://www.ncbi.nlm.nih.gov/pubmed/17014273}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological* • Adult • Anti-Retroviral Agents • Bereavement* • Demography • Female • Follow-Up Studies • Grief • HIV Infections • Humans • Male • Mass Screening • Questionnaires • Time Factors • drug therapy • epidemiology* • psychology* • therapeutic use}, Abstract = {The authors sought to study the longitudinal effects of a cognitive-behavioral group intervention for coping with AIDS bereavement among a diverse sample of adults who were HIV positive. Participants (N = 267) were randomly assigned to receive the 12-week intervention or individual therapy upon request. Measures were administered at baseline, postintervention, and 4-, 8-, and 12-month follow-ups. Longitudinal data were analyzed with linear mixed models to examine change in grief by condition across the study period and the effect of the intervention on grief through its interaction with psychiatric distress. The authors used the Grief Reaction Index to assess grief and the Symptom Checklist-90-Revised to assess global psychiatric distress. Participants in both conditions reported decreases in grief severity. However, among those with higher levels of psychiatric distress, participants in the group intervention had significantly lower grief severity scores compared with participants in the individual therapy condition. The long-term effectiveness of this AIDS-bereavement intervention for psychiatrically distressed people with HIV/AIDS supports the need for tailored interventions among those at risk for complicated grief responses.}, Language = {eng}, Doi = {10.1037/0278-6133.25.5.563}, Key = {fds254095} } @article{fds254096, Author = {Tarakeshwar, N and Krishnan, AK and Johnson, S and Solomon, S and Sikkema, K and Merson, M}, Title = {Living with HIV infection: perceptions of patients with access to care at a non-governmental organization in Chennai, India.}, Journal = {Culture, Health & Sexuality}, Volume = {8}, Number = {5}, Pages = {407-421}, Year = {2006}, Month = {September}, ISSN = {1369-1058}, url = {http://dx.doi.org/10.1080/13691050600859609}, Keywords = {Adult • Anti-HIV Agents • Cultural Characteristics • Female • HIV Infections • Health Knowledge, Attitudes, Practice* • Health Services Accessibility • Humans • India • Male • Patient Compliance* • Private Sector • Questionnaires • Social Perception* • Socioeconomic Factors • drug therapy • organization & administration • organization & administration* • psychology* • statistics & numerical data* • therapeutic use}, Abstract = {Through interviews, we examined explanatory frameworks of living with HIV infection among 50 HIV-positive individuals (23 women, 27 men) receiving care at a non-governmental organization in Chennai, India. Results were analysed according to three sets of issues, all of which were found to differ by gender: causal beliefs about HIV, impact of HIV, and care/treatment of HIV. HIV-positive participants attributed their infection to biological, moral and social causes, and the physical, financial and relationship dimensions of their lives were impacted upon by the infection. Furthermore, HIV-related stigma evoked fears about isolation and discrimination. Regarding care/treatment, men were most usually first initiated into the healthcare system while women often entered as a consequence of their partner's condition. Non-adherence to medication was reported by 32% of the participants due to financial constraints or side-effects. Although all participants were hopeful about a cure for HIV, women were less positive than men about treatment. Results highlight the importance of a gender-sensitive approach to HIV care, nuanced to accommodate an individual's gender, marital status and social background.}, Language = {eng}, Doi = {10.1080/13691050600859609}, Key = {fds254096} } @article{fds254072, Author = {Tarakeshwar, N and Hansen, NB and Kochman, A and Fox, A and Sikkema, KJ}, Title = {Resiliency among individuals with childhood sexual abuse and HIV: perspectives on addressing sexual trauma.}, Journal = {Journal of Traumatic Stress}, Volume = {19}, Number = {4}, Pages = {449-460}, Year = {2006}, Month = {August}, ISSN = {0894-9867}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16929500}, Keywords = {Adaptation, Psychological* • Adolescent • Adult • Child • Child Abuse, Sexual • Emotions • Female • HIV Infections • Humans • Male • Models, Psychological • New York City • Stress, Psychological • psychology • psychology*}, Abstract = {This study examined how resiliency (represented by optimism, social support, religiosity, and finding growth and meaning), within the context of perceived impact of sexual trauma and HIV-related stress, was linked to perspectives on addressing trauma among individuals (N=266) with HIV and childhood sexual abuse (CSA). Structural equation modeling analyses indicated that lower resiliency and greater HIV-related stress were related to negative feelings about addressing trauma, whereas greater resiliency and higher perceived impact of sexual trauma were associated with positive feelings about addressing trauma. Findings suggest that multiple factors influence perspectives on addressing trauma among individuals with HIV and CSA, and that resiliency might influence these attitudes.}, Language = {eng}, Doi = {10.1002/jts.20132}, Key = {fds254072} } @article{fds254074, Author = {Tate, DC and Van Den Berg and JJ and Hansen, NB and Kochman, A and Sikkema, KJ}, Title = {Race, social support, and coping strategies among HIV-positive gay and bisexual men.}, Journal = {Culture, Health & Sexuality}, Volume = {8}, Number = {3}, Pages = {235-249}, Year = {2006}, Month = {May}, ISSN = {1369-1058}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16801225}, Keywords = {Adaptation, Psychological • Adult • African Americans • Bisexuality • Cultural Characteristics • Cultural Diversity • European Continental Ancestry Group • HIV Infections • Homosexuality, Male • Humans • Interpersonal Relations • Male • New York City • Questionnaires • Self Concept • Social Support • Wisconsin • psychology*}, Abstract = {Few studies have examined the relation between race, social support, and coping, particularly among HIV-infected individuals. We examined the relation of race and social support to coping with HIV infection in a sample of 121 gay and bisexual men (64 African American, 57 White). Compared to White participants, African Americans reported higher use of multiple coping strategies. High levels of perceived social support were related to greater use of positive coping and seeking support; lower levels of social support were related to greater use of self-destructive coping. There were no race-related differences in social support, and no race by social support interactions. Possible explanations for observed cultural differences and coping challenges of African American gay and bisexual men with HIV are discussed.}, Language = {eng}, Doi = {10.1080/13691050600761268}, Key = {fds254074} } @article{fds253998, Author = {Hansen, NB and Sikkema, KJ}, Title = {Treating posttraumatic stress disorder in people with HIV.}, Volume = {21}, Number = {4}, Pages = {5-6}, Booktitle = {Focus: A Guide to AIDS Research and Counseling}, Year = {2006}, Month = {April}, ISSN = {1047-0719}, url = {http://dx.doi.org/10.1007/s10461-006-9149-8}, Keywords = {HIV Infections • Humans • Stress Disorders, Post-Traumatic • complications • complications* • drug therapy • therapy*}, Abstract = {Childhood sexual abuse is common among HIV-infected persons, though few empirically supported treatments addressing sexual abuse are available for men and women with HIV/AIDS. This study reports the outcome from a randomized controlled trial of a group intervention for coping with HIV and sexual abuse. A diverse sample of 202 HIV-positive men and women who were sexually abused as children was randomly assigned to one of three conditions: a 15-session HIV and trauma coping group intervention, a 15-session support group comparison condition, or a waitlist control (later randomly assigned to an intervention condition). Traumatic stress symptoms were assessed at baseline and post-intervention, with analysis conducted for the three-condition comparison followed by analysis of the two-condition comparison between the coping and support group interventions. Participants in the coping group intervention exhibited reductions in intrusive traumatic stress symptoms compared to the waitlist condition and in avoidant traumatic stress symptoms compared to the support group condition. No differences were found between the support group intervention and waitlist conditions. Tests of clinical significance documented the meaningfulness of change in symptoms.}, Language = {eng}, Doi = {10.1007/s10461-006-9149-8}, Key = {fds253998} } @article{fds254077, Author = {Anderson, ES and Wagstaff, DA and Heckman, TG and Winett, RA and Roffman, RA and Solomon, LJ and Cargill, V and Kelly, JA and Sikkema, KJ}, Title = {Information-Motivation-Behavioral Skills (IMB) Model: testing direct and mediated treatment effects on condom use among women in low-income housing.}, Journal = {Annals of Behavioral Medicine}, Volume = {31}, Number = {1}, Pages = {70-79}, Year = {2006}, Month = {February}, ISSN = {0883-6612}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16472041}, Keywords = {Adolescent • Adult • Condoms • Disclosure* • Female • Humans • Motivation* • Public Housing • Questionnaires • Social Behavior* • Socioeconomic Factors • statistics & numerical data* • utilization*}, Abstract = {The Information-Motivation-Behavioral Skills (IMB) model of HIV preventive behavior (1-4) specifies that treatment effects on behavior occur largely as the result of treatment effects on behavioral skills, which follow from effects on information and motivation.The objective was to determine whether the variables specified by the IMB model of HIV preventive behavior (1-4) accounted for the relation between an IMB-based treatment and resulting HIV preventive behavior (condom use).Women (n = 557) living in 18 low-income housing developments in 5 geographically dispersed cities were recruited to participate in an HIV-prevention study. Women (within housing developments) were randomly assigned to receive an IMB-based, HIV risk-avoidance intervention or a comparison intervention. Baseline and posttreatment (16 months after baseline) data were collected on condom use information, motivation (social norms, attitudes, intentions, and perceived risk), enactment of behavioral skills (condom negotiation and procurement), and rates of condom use in the past 2 months.The IMB intervention led to a 12% to 16% increase in condom use rates over the course, whereas the comparison intervention led to 2% decrease. In addition, the IMB treatment led to greater increases in condom use information, in the intentions and social norms components of motivation and the condom procurement and condom conversations components of behavioral skills. The IMB model provided an acceptable fit to the data (root mean square error of approximation < .05) and accounted for 50% of the variance in posttreatment condom use among the sample. Treatment effects on condom use were almost entirely mediated by the IMB variables; specifically, motivation and enactment of behavioral skills mediated the intervention's impact on condom use.These results provide supporting evidence as to how theoretical variables operate to effect change within a theory-based intervention and provide evidence as to the applicability of a prevailing theory of HIV risk behavior among low-income minority women.}, Language = {eng}, Doi = {10.1207/s15324796abm3101_11}, Key = {fds254077} } @article{fds254090, Author = {Tarakeshwar, N and Khan, N and Sikkema, KJ}, Title = {A relationship-based framework of spirituality for individuals with HIV.}, Journal = {Aids and Behavior}, Volume = {10}, Number = {1}, Pages = {59-70}, Year = {2006}, Month = {January}, ISSN = {1090-7165}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16489416}, Keywords = {Adaptation, Psychological • Adult • Culture • Family • Female • HIV Infections • Humans • Interpersonal Relations • Male • Quality of Life • Questionnaires • Spirituality* • psychology • psychology*}, Abstract = {Twenty HIV-positive individuals (10 male, 10 female) participated in interviews on their spiritual life. Interview themes suggest that the HIV diagnosis facilitated a relationship-based framework of spirituality. Relationships that formed this framework were: relationship with God/Higher Power, renewed engagement with life, and relationship with family. Within ''relationship with God/Higher Power,'' subthemes included gratitude for God's benevolent influence, spiritual struggles, and building connections with their Higher Power. Self care, transformation of life goals, and accepting mortality were subthemes for ''renewed engagement with life.'' Subthemes within ''relationship with family'' included finding a sense of purpose, finding support through families, and families as a source of strain. Overall, results suggest that interventions that integrate spirituality need to consider a notion of spirituality that goes beyond church attendance, prayer, and Bible reading. These interventions must include the positive aspects of spirituality and spiritual struggles that individuals with HIV may experience.}, Language = {eng}, Doi = {10.1007/s10461-005-9052-8}, Key = {fds254090} } @article{fds90824, Author = {CS Meade and KJ Sikkema}, Title = {Voluntary HIV testing among adults with severe mental illness: frequency and associated factors.}, Journal = {AIDS and behavior}, Volume = {9}, Number = {4}, Pages = {465-73}, Year = {2005}, Month = {December}, ISSN = {1090-7165}, url = {http://dx.doi.org/10.1007/s10461-005-9033-y}, Keywords = {AIDS Serodiagnosis* • Adult • Female • HIV Infections • Humans • Linear Models • Male • Mental Disorders • Middle Aged • Psychology • Risk Factors • Risk-Taking • Severity of Illness Index • complications* • diagnosis* • prevention & control • statistics & numerical data • transmission}, Abstract = {Adults with severe mental illness (SMI) are disproportionately affected by HIV/AIDS. This study describes the frequency and associated factors of HIV testing among psychiatric outpatients (N = 150) in a small Northeastern city. A structured clinical interview assessed demographic, psychosocial, behavioral, and psychiatric factors. In the past year, 41% of participants were HIV tested. A hierarchical linear regression model revealed the following multivariate correlates: lower educational attainment, HIV risk behavior, greater social support, homelessness, non-psychotic disorder, borderline personality disorder, and greater treatment utilization. Psychiatric factors remained significant correlates of HIV testing after accounting for psychosocial and behavioral factors. Although HIV testing occurred among a substantial proportion of participants, 45% of individuals who engaged in HIV risk behavior were not tested in the past year. Adults with SMI are in need of interventions promoting routine HIV testing and risk-reduction counseling.}, Language = {eng}, Doi = {10.1007/s10461-005-9033-y}, Key = {fds90824} } @article{fds254081, Author = {Meade, CS and Sikkema, KJ}, Title = {Voluntary HIV testing among adults with severe mental illness: frequency and associated factors.}, Journal = {Aids and Behavior}, Volume = {9}, Number = {4}, Pages = {465-473}, Year = {2005}, Month = {December}, ISSN = {1090-7165}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16323033}, Keywords = {Adolescent • Child • Cohort Studies • Coitus • Condoms • Female • HIV Infections • Humans • Male • Patient Compliance • Patient Education as Topic • Peer Group • Public Housing • Risk Assessment • Risk Reduction Behavior • Risk-Taking • Sexual Behavior • Sexual Partners • Substance Abuse, Intravenous • United States • methods* • prevention & control • prevention & control* • utilization}, Abstract = {Adults with severe mental illness (SMI) are disproportionately affected by HIV/AIDS. This study describes the frequency and associated factors of HIV testing among psychiatric outpatients (N = 150) in a small Northeastern city. A structured clinical interview assessed demographic, psychosocial, behavioral, and psychiatric factors. In the past year, 41% of participants were HIV tested. A hierarchical linear regression model revealed the following multivariate correlates: lower educational attainment, HIV risk behavior, greater social support, homelessness, non-psychotic disorder, borderline personality disorder, and greater treatment utilization. Psychiatric factors remained significant correlates of HIV testing after accounting for psychosocial and behavioral factors. Although HIV testing occurred among a substantial proportion of participants, 45% of individuals who engaged in HIV risk behavior were not tested in the past year. Adults with SMI are in need of interventions promoting routine HIV testing and risk-reduction counseling.}, Language = {eng}, Doi = {10.1007/s10461-005-9033-y}, Key = {fds254081} } @article{fds254092, Author = {Kloos, B and Gross, SM and Meese, KJ and Meade, CS and Doughty, JD and Hawkins, DD and Zimmerman, SO and Snow, DL and Sikkema, KJ}, Title = {Negotiating risk: knowledge and use of HIV prevention by persons with serious mental illness living in supportive housing.}, Journal = {American Journal of Community Psychology}, Volume = {36}, Number = {3-4}, Pages = {357-372}, Year = {2005}, Month = {December}, ISSN = {0091-0562}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16389505}, Keywords = {Acquired Immunodeficiency Syndrome • Adult • Anecdotes as Topic • Community Mental Health Services • Female • HIV Infections • Health Knowledge, Attitudes, Practice* • Humans • Interview, Psychological • Male • Mental Disorders • Mentally Ill Persons • Middle Aged • Public Housing* • Qualitative Research • Risk Factors • Risk-Taking* • prevention & control* • psychology*}, Abstract = {As a population, persons with serious mental illness (SMI) have an elevated risk for HIV infection. However, relatively little is known about how the risk of HIV has affected their lives, how persons with SMI evaluate their HIV risk, and what preventive measures they undertake. Furthermore, relatively little is known about community-based HIV prevention for persons with SMI as most interventions have been restricted to clinical settings. This report presents findings on the HIV-related experiences of persons with SMI living in supportive housing programs, one possible setting for implementing community-based HIV prevention with this population. The qualitative investigation interviewed 41 men and women living in five supportive housing programs. In-depth, qualitative interviews elicited discussion of research participants' (a) experiences with HIV, (b) knowledge about HIV and HIV prevention, (c) assessments of their own risk, (d) descriptions of how they apply their prevention knowledge, and (e) reports of barriers for HIV prevention. Research participants describe social networks that have substantial contact with persons affected by HIV. However, contrary to some expectations of persons with SMI, research participants report using HIV prevention knowledge in negotiating their risk of contracting HIV. The implications of these findings are discussed in terms of their relevance for implementing community-based HIV prevention for persons with SMI.}, Language = {eng}, Doi = {10.1007/s10464-005-8631-1}, Key = {fds254092} } @article{fds253995, Author = {Visser, M and Mundell, J and de Villiers, A and Sikkema, K and Jeffery, B}, Title = {Development of structured support groups for HIV-positive women in South Africa.}, Journal = {Sahara J : Journal of Social Aspects of Hiv/Aids Research Alliance}, Volume = {2}, Number = {3}, Pages = {333-343}, Year = {2005}, Month = {November}, ISSN = {1729-0376}, url = {http://dx.doi.org/10.1080/17290376.2005.9724858}, Abstract = {Women living with HIV in a stigmatising community need support to cope with their HIV status. In a process of action research, a structured support group programme was designed to meet the needs of women to cope with their diagnosis and interpersonal relationships. The emphasis was on identifying their needs and developing programme material to address those needs through group participation and interaction. The programme was pilot-tested at two sites located in two townships in Tshwane, South Africa. Feedback after each session made it possible to adjust the programme to the needs of the participants. In a formative evaluation, audio-taped sessions, process notes of facilitators, and experiences of the participants were used to identify therapeutic elements, the value of the groups and the problems in the implementation process. Women reported benefit from participation in the support groups. A 10-session structured programme to be used in support groups addressing the most important needs of HIV-positive women was developed.}, Doi = {10.1080/17290376.2005.9724858}, Key = {fds253995} } @article{fds253997, Author = {Tarakeshwar, N and Fox, A and Ferro, C and Khawaja, S and Kachman, A and Sikkema, KJ}, Title = {The connections between childhood sexual abuse and human immunodeficiency virus infection: Implications for interventions}, Journal = {Journal of Community Psychology}, Volume = {33}, Number = {6}, Pages = {655-672}, Publisher = {WILEY}, Year = {2005}, Month = {November}, ISSN = {0090-4392}, url = {http://dx.doi.org/10.1002/jcop.20077}, Abstract = {A qualitative study was conducted with 28 women who are human immunodeficiency virus (HIV)-positive and have experienced childhood sexual abuse (CSA) in order to examine (1) the challenges generated by the experience of sexual abuse and related coping strategies, (2) the impact of the HIV diagnosis on their coping strategies, and (3) the links perceived by the women between their CSA and HIV infection. The interviews revealed that CSA raised challenges in four areas: disclosure of the abuse, sexual problems, relationship difficulties, and psychological distress. The women used two strategies to cope with their CSA: illicit substances to numb their emotional distress and sexual activity, and alienation to gain control in relationships. When diagnosed with HIV, the women initially coped with their illness by using these two strategies. The women reported that, over time, they were able to accept their HIV illness, seek social support, find alternative sources of significance, and use spirituality to sustain their growth. However, they continued to suffer psychological distress related to their sexual trauma. Further, most of the women did not perceive any connection between the two traumas. Implications of these findings for secondary prevention interventions with women who have HIV and experience of CSA are discussed. © 2005 Wiley Periodicals, Inc.}, Doi = {10.1002/jcop.20077}, Key = {fds253997} } @article{fds253994, Author = {Tarakeshwar, N and Pearce, MJ and Sikkema, KJ}, Title = {Development and implementation of a spiritual coping group intervention for adults living with HIV/AIDS: A pilot study}, Journal = {Mental Health, Religion & Culture}, Volume = {8}, Number = {3}, Pages = {179-190}, Publisher = {Informa UK Limited}, Year = {2005}, Month = {September}, ISSN = {1367-4676}, url = {http://dx.doi.org/10.1080/13694670500138908}, Abstract = {The aims of the current study were to (1) describe a spirituality-oriented, group pilot intervention for HIV-positive adults, and (2) examine the preliminary impact of the intervention among a sample (N = 13) of adults living with HIV in an urban city in northeast United States. The 8-session intervention, based on the cognitive theory of stress and coping and the framework of spiritual coping, addressed stressors unique to HIV disease. Changes in spiritual coping and mental health were evaluated using a within group pretest-posttest design. Results revealed that, at post-intervention, participants reported higher self-rated religiosity, more use of positive spiritual coping, lower use of negative spiritual coping, and lower depression. Studies using a randomized, controlled design with larger samples of individuals with HIV are needed to determine the efficacy of a spiritual intervention when compared to a secular one. © 2005 Taylor & Francis Group Ltd.}, Doi = {10.1080/13694670500138908}, Key = {fds253994} } @article{fds287960, Author = {Sikkema, KJ and Anderson, ES and Kelly, JA and Winett, RA and Gore-Felton, C and Roffman, RA and Heckman, TG and Graves, K and Hoffmann, RG and Brondino, MJ}, Title = {Outcomes of a randomized, controlled community-level HIV prevention intervention for adolescents in low-income housing developments.}, Journal = {Aids}, Volume = {19}, Number = {14}, Pages = {1509-1516}, Year = {2005}, Month = {September}, ISSN = {0269-9370}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16135905}, Abstract = {OBJECTIVES:Youth are increasingly at risk for contracting HIV infection, and community-level interventions are needed to reduce behavioral risk. DESIGN:A randomized, controlled, multi-site community-level intervention trial was undertaken with adolescents living in 15 low-income housing developments in five US cities. METHODS:Baseline (n = 1172), short-term follow-up (n = 865), and long-term follow-up (n = 763) risk assessments were conducted among adolescents, ages 12-17, in all 15 housing developments. The developments were randomly assigned in equal numbers to each of three conditions: experimental community-level intervention (five developments); "state-of-the-science" skills training workshops (five developments); and, education-only delayed control intervention (five developments). RESULTS:At long-term follow-up, adolescents living in the housing developments receiving the community-level intervention were more likely to delay onset of first intercourse (85%) than those in the control developments (76%), while those in the workshop developments (78%) did not differ from control condition adolescents. Adolescents in both the community-level intervention (77%) and workshop (76%) developments were more likely to use a condom at last intercourse than those in control (62%) developments. CONCLUSIONS:Community-level interventions that include skills training and engage adolescents in neighborhood-based HIV prevention activities can produce and maintain reductions in sexual risk behavior, including delaying sexual debut and increasing condom use.}, Doi = {10.1097/01.aids.0000183128.39701.34}, Key = {fds287960} } @article{fds254075, Author = {Johnson-Masotti, AP and Pinkerton, SD and Sikkema, KJ and Kelly, JA and Wagstaff, DA}, Title = {Cost-effectiveness of a community-level HIV risk reduction intervention for women living in low-income housing developments.}, Journal = {The Journal of Primary Prevention}, Volume = {26}, Number = {4}, Pages = {345-362}, Year = {2005}, Month = {July}, ISSN = {0278-095X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15995803}, Keywords = {Adult • Community Health Planning* • Community Health Services • Cost of Illness • Cost-Benefit Analysis • Female • Focus Groups • HIV Infections • Humans • Models, Econometric • Poverty* • Primary Prevention • Program Evaluation • Prospective Studies • Public Housing* • Quality-Adjusted Life Years* • Risk Assessment • Risk Reduction Behavior* • United States • Urban Health • Women's Health Services • economics • economics* • epidemiology • prevention & control*}, Abstract = {We conducted a cost-effectiveness analysis of a multi-site community-level HIV prevention trial that enrolled women living in 18 low-income housing developments in 5 U.S. cities. A mathematical model of HIV transmission was used to estimate the number of HIV infections averted and quality-adjusted life years (QALYs) saved by the community-level intervention, based on data obtained from community-wide sexual behavior surveys at baseline and 12-month follow-up. Results indicated that the intervention prevented approximately 1 infection per 3500 women reached by the intervention, at a total cost of 174,845 dollars. The cost per QALY saved by the intervention was 37,433 dollars and the cost per HIV infection averted was 732,072 dollars. The community-level intervention was moderately cost-effective in comparison with other HIV prevention programs for at-risk women. Synergistic approaches to HIV prevention that combine community-level sexual norm change interventions with more intensive risk reduction programs for high-risk women are needed. EDITORS' STRATEGIC IMPLICATIONS: The authors present a promising and efficient community-level HIV prevention approach, with effects beyond the limited scope of individual or small group interventions. This paper represents an example of how an analysis of cost-effectiveness can provide policymakers with information needed for difficult decisions about prevention resource allocations.}, Language = {eng}, Doi = {10.1007/s10935-005-5392-2}, Key = {fds254075} } @article{fds253993, Author = {Tarakeshwar, N and Hansen, N and Kochman, A and Sikkema, KJ}, Title = {Gender, ethnicity and spiritual coping among bereaved HIV-positive individuals}, Journal = {Mental Health, Religion & Culture}, Volume = {8}, Number = {2}, Pages = {109-125}, Publisher = {Informa UK Limited}, Year = {2005}, Month = {June}, url = {http://dx.doi.org/10.1080/1367467042000240383}, Abstract = {We examined the influence of gender and ethnicity on coping strategies of 252 bereaved, HIV-positive individuals (65.1% male; 71% ethnic minorities [African-American and Hispanic]). Factor analyses of the Ways of Coping Questionnaire and Coping with Illness Scale yielded five coping subscales: Active, Avoidant, Social Support, Self-destructive, and Spiritual. Multivariate analyses of covariance revealed significant gender and ethnic group effects on spiritual coping, after controlling for social support, education, and sexual orientation. Of all subscales, only spiritual coping was not influenced by perceived social support. Women and ethnic minorities reported greater use of spiritual coping while White men reported the least use of spiritual coping. White women reported significantly greater use of avoidant coping than White men. Further, the relationship between spiritual coping and grief varied across gender and ethnicity. These results highlight the influence of gender and ethnicity in the use of spiritual coping and the importance of integrating spirituality in psychosocial interventions. © 2005 Taylor & Francis Ltd.}, Doi = {10.1080/1367467042000240383}, Key = {fds253993} } @article{fds254085, Author = {Meade, CS and Sikkema, KJ}, Title = {HIV risk behavior among adults with severe mental illness: a systematic review.}, Journal = {Clinical Psychology Review}, Volume = {25}, Number = {4}, Pages = {433-457}, Year = {2005}, Month = {June}, ISSN = {0272-7358}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15914265}, Keywords = {Adult • HIV Infections • Humans • Mental Disorders • Risk-Taking* • Severity of Illness Index • Sexual Behavior • Substance Abuse, Intravenous • epidemiology • epidemiology* • psychology • psychology*}, Abstract = {Adults with severe mental illness (SMI) have been disproportionately affected by the HIV/AIDS epidemic. This systematic review of the empirical literature on SMI documents the prevalence and correlates of HIV risk behaviors, discusses clinical implications for HIV prevention, and recommends directions for future research. Prevalence rates of HIV risk behaviors were estimated using weighted means, and findings on correlates were synthesized. Across reviewed studies (N=52), the majority of adults with SMI were sexually active, and many engaged in risk behaviors associated with HIV transmission (e.g., unprotected intercourse, multiple partners, injection drug use). HIV risk behaviors were correlated with factors from the following domains: psychiatric illness, substance use, childhood abuse, cognitive-behavioral factors, and social relationships. A proposed model illustrates the multiple pathways linking these domains to HIV risk behavior. Further research using improved methodologies (e.g., longitudinal designs, standardized measures, multivariate analyses) is needed to examine the broader social context in which HIV risk behavior occurs and identify underlying processes. HIV prevention efforts targeting adults with SMI must occur on multiple levels (e.g., individual, group, community, structural/policy), address several domains of influence (e.g., psychiatric illness, trauma history, social relationships), and be integrated into existing services (e.g., psychotherapy, substance abuse treatment, housing programs).}, Language = {eng}, Doi = {10.1016/j.cpr.2005.02.001}, Key = {fds254085} } @article{fds253991, Author = {Rogers, ME and Hansen, NB and Levy, BR and Tate, DC and Sikkema, KJ}, Title = {Optimism and coping with loss in bereaved HIV-infected men and women}, Journal = {Journal of Social and Clinical Psychology}, Volume = {24}, Number = {3}, Pages = {341-360}, Publisher = {Guilford Publications}, Year = {2005}, Month = {May}, ISSN = {0736-7236}, url = {http://dx.doi.org/10.1521/jscp.24.3.341.65619}, Abstract = {Bereavement due to AIDS-related loss is a severe Stressor, particularly for those who are themselves HIV-infected. Previous research investigating coping with loss has overlooked the effects of positive psychological states, such as optimism or hopefulness, and has focused instead upon negative coping outcomes, particularly psychological distress. Using an ethnically diverse cohort of 172 men and 92 women suffering from the combined Stressors of HIV infection and loss of loved ones to HIV/AIDS, we tested the hypotheses that active coping strategies are predictive of optimism and high levels of hope, and that avoidant coping strategies are predictive of pessimism and hopelessness. Hierarchical multiple regression analyses revealed that active coping was positively associated with optimism and negatively associated with hopelessness, and avoidant coping was negatively associated with optimism and positively associated with hopelessness. Regression analyses also showed that both depression and social support were significant predictors in the final models. Implications for improving the targeting and tailoring of interventions designed to improve coping and to reduce distress following bereavement are discussed.}, Doi = {10.1521/jscp.24.3.341.65619}, Key = {fds253991} } @article{fds253992, Author = {Sikkema, KJ}, Title = {HIV prevention among women in low-income housing developments: Issues and intervention outcomes in a place-based randomized controlled trial}, Journal = {The Annals of the American Academy of Political and Social Science}, Volume = {599}, Number = {1}, Pages = {52-70}, Publisher = {SAGE Publications}, Year = {2005}, Month = {May}, ISSN = {0002-7162}, url = {http://dx.doi.org/10.1177/0002716205274516}, Abstract = {The scope and urgency of the HIV epidemic requires the development and evaluation of community-level behavior change intervention strategies. A randomized, multisite community-level HIV prevention trial was undertaken with women living in eighteen low-income housing developments in five U.S. cities. In the nine experimental condition developments, an intervention was undertaken that included identifying opinion leaders to attend risk reduction workshops and to form Women's Health Councils to carry out community events to reach all residents and support risk reduction efforts. Baseline and twelve-month follow-up risk characteristics were assessed by surveying 690 women at both time points. In comparison to women in the control condition developments, women in the community intervention developments reported significant reductions in frequency of any unprotected intercourse and increases in the percentage of condom-protected inter-course occasions. Community-level interventions that engage women in neighborhood-based HIV prevention activities can bring about reductions in HIV risk-related sexual behavior.}, Doi = {10.1177/0002716205274516}, Key = {fds253992} } @article{fds254018, Author = {Sikkema, KJ and Hansen, NB and Meade, CS and Kochman, A and Lee, RS}, Title = {Improvements in health-related quality of life following a group intervention for coping with AIDS-bereavement among HIV-infected men and women.}, Journal = {Quality of Life Research}, Volume = {14}, Number = {4}, Pages = {991-1005}, Year = {2005}, Month = {May}, ISSN = {0962-9343}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16041896}, Keywords = {Adaptation, Psychological* • Adult • Bereavement* • Disease Progression • Female • HIV Seropositivity • Humans • Male • Middle Aged • Psychotherapy • Quality of Life • Self-Help Groups* • Sickness Impact Profile* • Treatment Outcome • United States • mortality • physiopathology* • psychology • psychology*}, Abstract = {BACKGROUND: AIDS-related bereavement is a severe life stressor that may be particularly distressing to persons themselves infected with HIV. Increasing evidence suggests that psychological health is associated with disease progression, HIV-related symptoms, and mortality. PURPOSE: This study assessed change in health-related quality of life among HIV + persons following a group intervention for coping with AIDS-related loss. METHODS: The sample included 235 HIV + men and women of diverse ethnicities and sexual orientations who had experienced an AIDS-related loss within the previous 2 years. Participants were randomly assigned to a 12-week cognitive-behavioral bereavement coping group intervention or offered individual psychotherapy upon request. Quality of life was assessed at baseline and 2 weeks after the intervention. RESULTS: Participants in the group intervention demonstrated improvements in general health-related and HIV-specific quality of life, while those in the comparison remained the same or deteriorated. Effect sizes indicated that the majority of change occurred in women. CONCLUSION: This bereavement group aimed at improving coping with grief also had a positive impact on health-related quality of life among HIV + men and women, and suggests that cognitive-behavioral interventions may have a broad impact on both emotional and physical health.}, Language = {eng}, Doi = {10.1007/s11136-004-2959-0}, Key = {fds254018} } @article{fds254086, Author = {Sikkema, KJ and Hansen, NB and Tarakeshwar, N and Kochman, A and Tate, DC and Lee, RS}, Title = {The clinical significance of change in trauma-related symptoms following a pilot group intervention for coping with HIV-AIDS and childhood sexual trauma.}, Journal = {Aids and Behavior}, Volume = {8}, Number = {3}, Pages = {277-291}, Year = {2004}, Month = {September}, ISSN = {1090-7165}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15475675}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological* • Adolescent • Adult • Child • Child Abuse, Sexual • Comorbidity • Connecticut • Crime Victims • Female • Follow-Up Studies • HIV Infections • Health Knowledge, Attitudes, Practice • Humans • Male • Middle Aged • New York City • Personality Inventory • Pilot Projects • Psychotherapy, Group* • Rape • Spouse Abuse • Stress Disorders, Post-Traumatic • Treatment Outcome • Urban Population* • Violence • diagnosis • prevention & control • psychology • psychology* • therapy*}, Abstract = {The association between sexual abuse and HIV risk is well documented, yet little empirical data exists on treatment approaches integrating the psychological impact of sexual abuse and HIV disease. This study examined the clinical significance of change on sexual-trauma-related stress following a coping group intervention study among 28 women and men with HIV-AIDS and a history of childhood sexual abuse. More than 75% of participants showed improvement on 1 or more subscales of the Trauma Symptom Inventory, with the majority of improvements within domains related to trauma symptoms and behavioral difficulties. Most observed gains were modest, but are considered meaningful in the context of stressors encountered by this disenfranchised sample, which was diverse with respect to race, sexual orientation, and psychiatric comorbidity. These preliminary findings support the need for the conduct of research trials to identify mental health and secondary prevention intervention models that can assist those with HIV-AIDS who have experienced childhood sexual abuse.}, Language = {eng}, Doi = {10.1023/b:aibe.0000044075.12845.75}, Key = {fds254086} } @article{fds254082, Author = {Sikkema, KJ and Brondino, MJ and Anderson, ES and Gore-Felton, C and Kelly, JA and Winett, RA and Heckman, TG and Roffman, RA}, Title = {HIV risk behavior among ethnically diverse adolescents living in low-income housing developments.}, Journal = {Journal of Adolescent Health}, Volume = {35}, Number = {2}, Pages = {141-150}, Year = {2004}, Month = {August}, ISSN = {1054-139X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15261643}, Keywords = {Adolescent • Child • Female • HIV Infections • Health Knowledge, Attitudes, Practice • Humans • Logistic Models • Male • Poverty* • Public Housing* • Questionnaires • Risk Factors • Risk-Taking* • Sexual Behavior* • United States • Urban Health • ethnology • etiology* • prevention & control}, Abstract = {PURPOSE: To describe patterns and predictors of HIV risk behaviors among ethnically diverse, low-income adolescents. METHODS: Computer-assisted surveys were administered to 1172 adolescents between the ages of 12 and 17 years living in 15 low-income housing developments in three urban areas in the United States to characterize and identify predictors of HIV risk behavior. Data were analyzed using multinomial logistic regression to identify variables predictive of "no risk," "lower risk," and "higher risk" group classification. RESULTS: Most adolescents were not yet sexually active; nonetheless, a subset of youth reported high rates of HIV risk-related behaviors. HIV risk was highest among adolescents who were older, had weaker intentions to reduce risk, stronger beliefs that their sexual partners did not favor risk-reduction, lower risk-reduction behavioral skills, higher risk-reduction outcome expectation, and higher rates of substance use. CONCLUSIONS: HIV prevention efforts are needed that are tailored to ethnically diverse communities of adolescents, including those in early adolescence and those at highest risk.}, Language = {eng}, Doi = {10.1016/j.jadohealth.2003.09.008}, Key = {fds254082} } @article{fds254087, Author = {Sikkema, KJ and Hansen, NB and Kochman, A and Tate, DC and Difranceisco, W}, Title = {Outcomes from a randomized controlled trial of a group intervention for HIV positive men and women coping with AIDS-related loss and bereavement.}, Journal = {Death Studies}, Volume = {28}, Number = {3}, Pages = {187-209}, Year = {2004}, Month = {April}, ISSN = {0748-1187}, url = {http://www.ncbi.nlm.nih.gov/pubmed/15053030}, Keywords = {Adaptation, Psychological* • Bereavement* • Female • HIV Infections • Humans • Male • Psychotherapy, Group* • Sex Factors • Stress, Psychological • Treatment Outcome • United States • psychology*}, Abstract = {The purpose of this study was to examine the impact of a group coping intervention for HIV-positive men and women who have lost a loved one(s) to AIDS in the past 2 years. Two hundred thirty-five participants, diverse with respect to race/ethnicity and sexual orientation, were randomly assigned to a 12-week cognitive-behavioral group intervention or to an individual therapy on request comparison condition. Measures assessing grief and psychiatric distress were administered at baseline and 2 weeks post-intervention period. Although a strong gender effect was observed in outcome, both men and women participating in the group intervention demonstrated significantly more reduction in psychiatric distress than controls. Further, women in the group intervention demonstrated significant reductions in grief and depressive symptoms over men in both conditions and women in the comparison condition. Brief cognitive-behavioral group interventions for coping with grief have a positive impact on the psychiatric functioning of HIV-positive participants. This appears to be especially true for HIV-positive women; a group not previously focused on in clinical research related to AIDS bereavement.}, Language = {eng}, Doi = {10.1080/07481180490276544}, Key = {fds254087} } @article{fds90846, Author = {TG Heckman and ES Anderson and KJ Sikkema and A Kochman and SC Kalichman, T Anderson}, Title = {Emotional distress in nonmetropolitan persons living with HIV disease enrolled in a telephone-delivered, coping improvement group intervention.}, Journal = {Health psychology : official journal of the Division of Health Psychology, American Psychological Association}, Volume = {23}, Number = {1}, Pages = {94-100}, Year = {2004}, Month = {January}, ISSN = {0278-6133}, url = {http://dx.doi.org/10.1037/0278-6133.23.1.94}, Keywords = {Adaptation, Psychological* • Adult • Depressive Disorder, Major • Female • HIV Seropositivity • Hotlines* • Humans • Male • Patient Acceptance of Health Care • Severity of Illness Index • Social Support* • Stereotyping • diagnosis • epidemiology* • psychology*}, Abstract = {The study delineated depressive symptoms and modeled emotional distress in persons living with HIV disease in nonmetropolitan areas of 13 U.S. states. Participants (N=329) were enrolled in a randomized clinical trial of a telephone-delivered, coping improvement group intervention, and 60% reported moderate or severe levels of depressive symptomatology on the Beck Depression Inventory. Structural equation modeling indicated that participants who experienced more severe HIV symptomatology, received less social support, and engaged in more avoidant coping also experienced more emotional distress (a latent construct comprising depressive symptoms and emotional well-being). Greater HIV-related stigma and rejection by family led to more emotional distress, with social support and avoidant coping mediating almost entirely the effects of the former 2 variables. The model accounted for 72% of the variance in emotional distress in nonmetropolitan persons living with HIV disease.}, Language = {eng}, Doi = {10.1037/0278-6133.23.1.94}, Key = {fds90846} } @article{fds254091, Author = {Heckman, TG and Anderson, ES and Sikkema, KJ and Kochman, A and Kalichman, SC and Anderson, T}, Title = {Emotional distress in nonmetropolitan persons living with HIV disease enrolled in a telephone-delivered, coping improvement group intervention.}, Journal = {Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association}, Volume = {23}, Number = {1}, Pages = {94-100}, Year = {2004}, Month = {January}, ISSN = {0278-6133}, url = {http://www.ncbi.nlm.nih.gov/pubmed/14756608}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological* • Adult • Bereavement* • Depression • Female • HIV Infections • HIV Seropositivity • Health Status* • Humans • Male • Middle Aged • New York • Psychiatric Status Rating Scales • Regression Analysis • Social Support • Stress, Psychological • Wisconsin • etiology* • psychology • psychology*}, Abstract = {The study delineated depressive symptoms and modeled emotional distress in persons living with HIV disease in nonmetropolitan areas of 13 U.S. states. Participants (N=329) were enrolled in a randomized clinical trial of a telephone-delivered, coping improvement group intervention, and 60% reported moderate or severe levels of depressive symptomatology on the Beck Depression Inventory. Structural equation modeling indicated that participants who experienced more severe HIV symptomatology, received less social support, and engaged in more avoidant coping also experienced more emotional distress (a latent construct comprising depressive symptoms and emotional well-being). Greater HIV-related stigma and rejection by family led to more emotional distress, with social support and avoidant coping mediating almost entirely the effects of the former 2 variables. The model accounted for 72% of the variance in emotional distress in nonmetropolitan persons living with HIV disease.}, Language = {eng}, Doi = {10.1037/0278-6133.23.1.94}, Key = {fds254091} } @article{fds253893, Author = {Sikkema, KJ}, Title = {HIV prevention among young adults}, Booktitle = {Applied Developmental Science: An Encyclopedia of Research, Policies, and Programs}, Publisher = {Sage}, Editor = {Fisher, C and Lerner, R}, Year = {2004}, Key = {fds253893} } @article{fds253894, Author = {Sikkema, KJ and Kailchman, SC}, Title = {HIV/AIDS}, Pages = {167-182}, Booktitle = {Clinical Handbook of Health Psychology: A Practical Guide to Effective Interventions}, Publisher = {Hogrefe & Huber Publishers}, Editor = {Camic, P and Knight, S}, Year = {2004}, Key = {fds253894} } @article{fds253895, Author = {Sikkema, KJ and Heckman, TG and Kochman, A}, Title = {Depressive symptoms in older adults living with HIV disease}, Pages = {37-54}, Booktitle = {HIV/AIDS and Older Adults: Challenges for Individuals, Families, and Communities}, Publisher = {Springer Publishing Co}, Editor = {Emlet, C}, Year = {2004}, Key = {fds253895} } @article{fds287959, Author = {Sikkema, KJ and Kochman, A and DiFranceisco, W and Kelly, JA and Hoffmann, RG}, Title = {AIDS-related grief and coping with loss among HIV-positive men and women.}, Journal = {Journal of Behavioral Medicine}, Volume = {26}, Number = {2}, Pages = {165-181}, Year = {2003}, Month = {April}, ISSN = {0160-7715}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12776385}, Abstract = {AIDS-related grief was examined and its association with coping among HIV-positive men and women explored. AIDS-related grief, psychological distress and coping were examined among a sample of 268 HIV-infected individuals, diverse with respect to gender, ethnicity, and sexual orientation. Participants exhibited elevated scores on measures of grief reaction and psychological distress including depressive symptoms, anxiety, and traumatic stress related to their losses. Hierarchical regression analyses revealed that severity of grief reaction was associated with escape-avoidance and self-controlling coping strategies, type of loss, depressive symptoms, and history of injection drug use. Interventions are needed to enhance coping and reduce psychological distress associated with the unique bereavement experienced by people living with HIV- and AIDS-related grief.}, Doi = {10.1023/a:1023086723137}, Key = {fds287959} } @article{fds253988, Author = {Heckman, TG and Kochman, A and Sikkema, KJ}, Title = {Depressive symptoms in older adults living with HIV disease: Application of the chronic illness quality of life model}, Journal = {Journal of Mental Health and Aging}, Volume = {8}, Number = {4}, Pages = {267-279}, Year = {2002}, Month = {December}, Abstract = {The current study delineated rates and predictors of depressive symptomatology in 83 persons 50 years of age and older living with HIV/AIDS in two large US cities. The Chronic Illness Quality of Life Model (CIQOL), which posits that emotional distress in HIV-infected persons is a function of AIDS-related stigma, barriers to health care and social services, physical well-being, social support, and engagement coping, served as the investigation's conceptual foundation. Approximately 25% of HIV-infected older adults reported elevated levels of depressive symptoms. Depressive symptomatology was most strongly related to poor physical well-being and less social support. The CIQOL Model accounted for 41% of the variance in depressive symptoms in this group. As improved clinical care enables HIV-infected persons to live longer, mental health interventions that are sensitive to the complex dynamics of HIV/AIDS and aging are urgently needed.}, Key = {fds253988} } @article{fds254080, Author = {Kalichman, SC and Sikkema, KJ and DiFonzo, K and Luke, W and Austin, J}, Title = {Emotional adjustment in survivors of sexual assault living with HIV-AIDS.}, Journal = {Journal of Traumatic Stress}, Volume = {15}, Number = {4}, Pages = {289-296}, Year = {2002}, Month = {August}, ISSN = {0894-9867}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12224800}, Keywords = {Adaptation, Psychological* • Adult • Analysis of Variance • Female • HIV Infections • Humans • Male • Mental Disorders • Multivariate Analysis • Rape • Risk-Taking • Sexual Behavior • Substance-Related Disorders • United States • epidemiology • psychology* • statistics & numerical data}, Abstract = {This study examined history of sexual assault in 357 men and women living with HIV-AIDS. Participants completed measures of demographic characteristics, sexual assault history, emotional distress and psychiatric symptoms, substance use, and sexual behaviors. Results showed that 68% of women and 35% of men living with HIV-AIDS reported a history of sexual assault since age 15. History of sexual assault was related to history of substance use and mental health treatment. Sexual assault survivors reported greater anxiety, depression, and symptoms of borderline personality and were significantly more likely to report recent unprotected intercourse than persons who had not been sexually assaulted. Results suggest tailoring secondary prevention interventions to meet the needs of HIV-positive survivors of sexual assault.}, Language = {eng}, Doi = {10.1023/a:1016247727498}, Key = {fds254080} } @article{fds254078, Author = {Heckman, TG and Heckman, BD and Kochman, A and Sikkema, KJ and Suhr, J and Goodkin, K}, Title = {Psychological symptoms among persons 50 years of age and older living with HIV disease.}, Journal = {Aging & Mental Health}, Volume = {6}, Number = {2}, Pages = {121-128}, Year = {2002}, Month = {May}, ISSN = {1360-7863}, url = {http://www.ncbi.nlm.nih.gov/pubmed/12028880}, Keywords = {Aged • Female • HIV Infections • Health Services Accessibility • Health Surveys • Humans • Male • Mental Disorders • Mental Health* • Middle Aged • Prejudice • Psychiatric Status Rating Scales • Quality of Life • Social Support • Stress, Psychological • complications* • etiology* • psychology*}, Abstract = {Although persons 50 years of age and older account for 10% of all US AIDS cases, the mental health needs of this growing group remain largely overlooked. The current study delineated patterns and predictors of psychological symptoms amongst late middle-aged and older adults living with HIV/AIDS in two large US cities. In late 1998, 83 HIV-infected individuals 50-plus years of age (M = 55.2, Range = 50-69) completed self-report surveys eliciting data on psychological symptomatology, HIV-related life-stressor burden, social support, barriers to health care and social services, and sociodemographic characteristics. Based on the Beck Depression Inventory, 25% of participants reported 'moderate' or 'severe' levels of depression. HIV-infected older adults also evidenced an elevated number of symptoms characteristic of somatization. A hierarchical multiple regression analysis revealed that HIV-infected older adults who endorsed more psychological symptoms also reported more HIV-related life-stressor burden, less support from friends, and reduced access to health care and social services due to AIDS-related stigma. As the impact of HIV on older communities continues to increase, geropractitioners must be prepared to provide care to greater numbers of HIV-infected older adults, a substantial minority of whom will present with complex comorbid physical and mental health conditions.}, Language = {eng}, Doi = {10.1080/13607860220126709a}, Key = {fds254078} } @article{fds253907, Author = {Sikkema (NIMH multisite), KJ}, Title = {Childhood sexual abuse and risk behaving among men at high risk for HIV infection}, Journal = {Am J Public Health}, Volume = {92}, Number = {2}, Pages = {214-219}, Publisher = {American Public Health Association}, Year = {2002}, ISSN = {1541-0048}, Key = {fds253907} } @article{fds253989, Author = {Lee, RS and Kochman, A and Sikkema, KJ}, Title = {Internalized stigma among people living with HIV-AIDS}, Journal = {AIDS and Behavior}, Volume = {6}, Number = {4}, Pages = {309-319}, Year = {2002}, url = {http://dx.doi.org/10.1023/A:1021144511957}, Abstract = {HIV is recognized as a highly stigmatized disease; however, there has been a lack of research on the internalization of this stigma by seropositive people. This study examined internalized stigma among HIV-positive men and women (N = 268) in Milwaukee and Madison, Wisconsin, and New York City. The majority of the sample experienced internalized stigma related to their HIV status. Individuals who experienced high internalized HIV stigma (IHS) had been diagnosed with HIV more recently, their families were less accepting of their illness, they were less likely to ever have attended an HIV support group, and they knew fewer people with HIV. Individuals with high IHS also worried more about spreading their infection to others. Heterosexuals and participants from Wisconsin experienced higher levels of IHS. Hierarchical regression analyses showed that IHS contributed significantly to levels of depression, anxiety, and hopelessness after controlling for the effects of key behavioral and psychosocial variables.}, Doi = {10.1023/A:1021144511957}, Key = {fds253989} } @article{fds253910, Author = {Murphy, DA and Stein, JA and Schlenger, W and Maibach, E and National Institute of Mental Health Multisite HIV Prevention Trial Group and National Institutes of Health}, Title = {Conceptualizing the multidimensional nature of self-efficacy: assessment of situational context and level of behavioral challenge to maintain safer sex. National Institute of Mental Health Multisite HIV Prevention Trial Group.}, Journal = {Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association}, Volume = {20}, Number = {4}, Pages = {281-290}, Publisher = {American Psychological Association}, Year = {2001}, Month = {July}, ISSN = {1930-7810}, url = {http://dx.doi.org/10.1037/0278-6133.20.4.281}, Abstract = {A. Bandura (1991) argued that self-efficacy measurement should be specific both to the situation in which the behavior occurs and level of challenge in that situation. Measures consistent with the 2 dimensions were developed with graded challenge levels and differing gender-appropriate situations. Participants were 1,496 controls in the National Institute of Mental Health Multisite HIV Prevention Trial recruited from STD clinics and health service centers (925 women and 571 men). The authors tested 4 separate-sex confirmatory factor analysis models as follows: (a) Condom negotiation efficacy as a unitary construct across situations and gradation of difficulty; (b) situation as preeminent, which transfers across skills whatever the gradation of difficulty; (c) skill as predominant, irrespective of situation; and (d) a multidimensional design that simultaneously accounts for both situation and graded difficulty. Consistent with Bandura's theory, the multidimensional model provided the best fit for both samples.}, Doi = {10.1037/0278-6133.20.4.281}, Key = {fds253910} } @article{fds90841, Author = {TG Heckman and A Kochman and KJ Sikkema and SC Kalichman and J Masten and J Bergholte, S Catz}, Title = {A pilot coping improvement intervention for late middle-aged and older adults living with HIV/AIDS in the USA.}, Journal = {AIDS care}, Volume = {13}, Number = {1}, Pages = {129-39}, Year = {2001}, Month = {February}, ISSN = {0954-0121}, url = {http://dx.doi.org/10.1080/09540120020018233}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological* • Female • Humans • Male • Mental Health Services • Middle Aged • Pilot Projects • United States • organization & administration • psychology • rehabilitation*}, Abstract = {As AIDS becomes more prevalent among late middle-aged and older adults, mental health support services that facilitate the coping and adjustment efforts of this group are increasingly needed. The current article: (1) outlines a coping improvement group intervention for HIV-infected older adults; and (2) examines the efficacy of the intervention utilizing a small sample (N = 16) of older adults living with HIV/AIDS in Milwaukee, Wisconsin and New York City. The intervention focused on enabling HIV-infected older adults to accurately appraise sources of stress, develop adaptive coping responses and access social support resources to facilitate coping efforts. An evaluation of this pilot intervention, conducted using a pretest-posttest, no control group design, revealed that the intervention increased participants' perceptions of social support, produced higher perceptions of social wellbeing and enabled participants to engage in more planful problem solving, confrontive coping and future optimism. Intervention participants also experienced less stressor burden associated with AIDS-related loss and health concerns. While the current intervention showed potential to facilitate the adjustment efforts of HIV-infected older adults, randomized clinical trials of this intervention with larger samples are needed before its appropriateness for this population can be determined.}, Language = {eng}, Doi = {10.1080/09540120020018233}, Key = {fds90841} } @article{fds254093, Author = {Heckman, TG and Kochman, A and Sikkema, KJ and Kalichman, SC and Masten, J and Bergholte, J and Catz, S}, Title = {A pilot coping improvement intervention for late middle-aged and older adults living with HIV/AIDS in the USA.}, Journal = {Aids Care Psychological and Socio Medical Aspects of Aids/Hiv}, Volume = {13}, Number = {1}, Pages = {129-139}, Year = {2001}, Month = {February}, ISSN = {0954-0121}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11177470}, Keywords = {Adaptation, Psychological • Adult • Analysis of Variance • Female • HIV Infections • Humans • Male • Middle Aged • Multivariate Analysis • Personal Satisfaction* • Quality of Life* • Regression Analysis • Social Support • Wisconsin • nursing • psychology*}, Abstract = {As AIDS becomes more prevalent among late middle-aged and older adults, mental health support services that facilitate the coping and adjustment efforts of this group are increasingly needed. The current article: (1) outlines a coping improvement group intervention for HIV-infected older adults; and (2) examines the efficacy of the intervention utilizing a small sample (N = 16) of older adults living with HIV/AIDS in Milwaukee, Wisconsin and New York City. The intervention focused on enabling HIV-infected older adults to accurately appraise sources of stress, develop adaptive coping responses and access social support resources to facilitate coping efforts. An evaluation of this pilot intervention, conducted using a pretest-posttest, no control group design, revealed that the intervention increased participants' perceptions of social support, produced higher perceptions of social wellbeing and enabled participants to engage in more planful problem solving, confrontive coping and future optimism. Intervention participants also experienced less stressor burden associated with AIDS-related loss and health concerns. While the current intervention showed potential to facilitate the adjustment efforts of HIV-infected older adults, randomized clinical trials of this intervention with larger samples are needed before its appropriateness for this population can be determined.}, Language = {eng}, Doi = {10.1080/09540120020018233}, Key = {fds254093} } @article{fds253897, Author = {Sikkema, KJ and Kalichman, SC and Somlai, AM}, Title = {Community involvement in HIV-AIDS prevention}, Pages = {159-175}, Booktitle = {Integrating Behavioral and Social Sciences in Public Health}, Publisher = {American Psychological Association}, Editor = {Schneiderman, N and Speers, M and Silva, J and Tomes, H and Gentry, J}, Year = {2001}, Key = {fds253897} } @article{fds253908, Author = {Sikkema (NIMH Multisite) and KJ}, Title = {A test of factors mediating the relationship between unwanted sexual activity during childhood and risky sexual practices among women enrolled in the NIMH Multisite HIV prevention trial}, Journal = {Women and Health}, Volume = {33}, Pages = {163-180}, Year = {2001}, Key = {fds253908} } @article{fds253909, Author = {Sikkema (NIMH Multisite) and KJ}, Title = {Social-cognitive theory mediators of behavior change in the National Institute of Mental Health Multisite HIV Prevention Trial}, Journal = {Health Psychology}, Volume = {20}, Pages = {369-376}, Publisher = {American Psychological Association}, Year = {2001}, ISSN = {1930-7810}, Key = {fds253909} } @article{fds254076, Author = {Sikkema, KJ and Kalichman, SC and Hoffmann, R and Koob, JJ and Kelly, JA and Heckman, TG}, Title = {Coping strategies and emotional wellbeing among HIV-infected men and women experiencing AIDS-related bereavement.}, Journal = {Aids Care Psychological and Socio Medical Aspects of Aids/Hiv}, Volume = {12}, Number = {5}, Pages = {613-624}, Year = {2000}, Month = {October}, ISSN = {0954-0121}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11218547}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological* • Adult • Bereavement* • Depression • Female • HIV Infections • Humans • Male • Middle Aged • Prevalence • Regression Analysis • Social Support • Stress, Psychological • Wisconsin • epidemiology • psychology • psychology*}, Abstract = {AIDS influences the psychological coping not only of the person with the disease but also those close to that individual. Following a death from AIDS, family members and friends may experience atypical bereavement. Bereavement coping challenges can be especially difficult and pronounced for persons who are themselves HIV-positive. The prevalence of AIDS-related bereavement and psychosocial predictors of grief severity were examined in an ethnically diverse sample of 199 HIV-infected men and women. Eighty per cent of HIV-positive respondents had experienced the loss of someone close to AIDS, the majority of whom had sustained multiple and repetitive losses. Two-thirds of the participants who had experienced an AIDS-related loss reported grief symptoms in the past month. Hierarchical regression analyses revealed that grief was most closely associated with emotional suppression and avoiding coping strategies, with residual variance related to depression. Interventions for AIDS-related bereavement that reduce distress and maladaptive ways of coping are needed in order to meet the secondary prevention needs of bereaved people living with HIV/AIDS.}, Language = {eng}, Doi = {10.1080/095401200750003798}, Key = {fds254076} } @article{fds253987, Author = {Heckman, TG and Kochman, A and Sikkema, KJ and Kalichman, SC and Masten, J and Goodkin, K}, Title = {Late middle-aged and older men living with HIV/AIDS: race differences in coping, social support, and psychological distress.}, Journal = {Journal of the National Medical Association}, Volume = {92}, Number = {9}, Pages = {436-444}, Year = {2000}, Month = {September}, ISSN = {1943-4693}, url = {http://www.ncbi.nlm.nih.gov/pubmed/11052457}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological* • African Americans • African Continental Ancestry Group* • Aged • Data Collection • European Continental Ancestry Group* • Female • Humans • Male • Middle Aged • New York City • Social Support* • Stress, Psychological* • Wisconsin • epidemiology • ethnology* • psychology*}, Abstract = {Although AIDS mental health research has recently devoted more attention to the psychosocial needs of older adults living with human immunodeficiency virus (HIV) disease, studies of this population have typically combined older African-American and white participants into one large sample, thereby neglecting potential race differences. The current study examined race differences in stressor burden, ways of coping, social support, and psychological distress among late middle-aged and older men living with HIV/AIDS. Self-administered surveys were completed by 72 men living with HIV/AIDS in New York City and Milwaukee, WI (mean age = 53.4 years). Older African-American and white men experienced comparable levels of stress associated with AIDS-related discrimination, AIDS-related bereavement, financial dilemmas, lack of information and support, relationship difficulties, and domestic problems. However, in responses to these stressors, older African-American men more frequently engaged in adaptive coping strategies, such as greater positive reappraisal and a stronger resolve that their future would be better. Compared to their African-American counterparts, HIV-infected older white men reported elevated levels of depression, anxiety, interpersonal hostility, and somatization. African-American men also received more support from family members and were less likely to disclose their HIV serostatus to close friends. As AIDS becomes more common among older adults, mental health-interventions will increasingly be needed for this group. The development of intervention programs for this group should pay close attention to race-related differences in sociodemographic, psychosocial, and behavioral characteristics.}, Language = {eng}, Doi = {10.1080/09540120020018233}, Key = {fds253987} } @article{fds254098, Author = {Kalichman, SC and Heckman, T and Kochman, A and Sikkema, K and Bergholte, J}, Title = {Depression and thoughts of suicide among middle-aged and older persons living with HIV-AIDS.}, Journal = {Psychiatric Services (Washington, D.C.)}, Volume = {51}, Number = {7}, Pages = {903-907}, Year = {2000}, Month = {July}, ISSN = {1075-2730}, url = {http://dx.doi.org/10.1176/appi.ps.51.7.903}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological • Aged • Depressive Disorder • Female • HIV Infections • Health Services Needs and Demand • Humans • Male • Middle Aged • Multivariate Analysis • New York City • Prevalence • Quality of Life • Social Support • Suicide • Wisconsin • epidemiology • prevention & control* • psychology* • virology*}, Abstract = {OBJECTIVE: This study examined the prevalence and characteristics of suicidal ideation among middle-aged and older persons who have HIV infection or AIDS. METHODS: A total of 113 subjects older than age 45 who had HIV-AIDS were recruited from AIDS service organizations in Milwaukee, Wisconsin, and New York City. Participants completed confidential questionnaires covering suicidal ideation, emotional distress, quality of life, coping, and social support. RESULTS: Twenty-seven percent of respondents reported having thought about taking their own life in the previous week. Those who had thought about suicide reported greater levels of emotional distress and poorer health-related quality of life than those who had not considered suicide. They were also significantly more likely to use escape and avoidance strategies for coping with HIV infection and less likely to use positive-reappraisal coping. Those who had thought about suicide also were more likely to have disclosed their HIV status to the people close to them, and yet they perceived receiving significantly less social support from friends and family. With the exceptions of physical functioning and coping strategies, differences between those who had contemplated suicide and those who had not remained unchanged after controlling for symptoms of depression. CONCLUSIONS: Persons who are in midlife and older and are living with HIV-AIDS experience significant emotional distress and thoughts of suicide, suggesting a need for targeted interventions to improve mental health and prevent suicide.}, Language = {eng}, Doi = {10.1176/appi.ps.51.7.903}, Key = {fds254098} } @article{fds253985, Author = {Kalichman, SC and Kelly, JA and Sikkema, KJ and Koslov, AP and Shaboltas, A and Granskaya, J}, Title = {The emerging AIDS crisis in Russia: review of enabling factors and prevention needs.}, Journal = {International Journal of Std & Aids}, Volume = {11}, Number = {2}, Pages = {71-75}, Year = {2000}, Month = {February}, ISSN = {0956-4624}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10678472}, Keywords = {Acquired Immunodeficiency Syndrome--prevention and control* • Biology • Developed Countries • Diseases • Eastern Europe* • Economic Factors* • Epidemics--prevention and control* • Europe • Hiv Infections--prevention and control* • Infections • Literature Review* • New Independent States • Reproductive Tract Infections • Risk Factors* • Russia • Sexually Transmitted Diseases--prevention and control* • Viral Diseases}, Abstract = {Eastern Europe is experiencing increased rates of HIV/AIDS, and the Russian Federation is among the countries with the most alarming case rate increases. Behavioural and biological studies demonstrate that the transmission of HIV in Russia is occurring as a result of injection drug use, homosexual, and heterosexual risk behaviours. Factors that promote risk and therefore enable HIV transmission in Russia parallel those found in other countries, including epidemics of other sexually transmitted infections, economic instability, poverty, and social factors such as gender roles. Research is urgently needed to better understand and forecast the HIV epidemic in Russia, as well as to develop effective interventions to prevent a Russian AIDS crisis.}, Language = {eng}, Doi = {10.1177/095646240001100201}, Key = {fds253985} } @article{fds253986, Author = {Sikkema, KJ and Kelly, JA and Winett, RA and Solomon, LJ and Cargill, VA and Roffman, RA and McAuliffe, TL and Heckman, TG and Anderson, EA and Wagstaff, DA and Norman, AD and Perry, MJ and Crumble, DA and Mercer, MB}, Title = {Outcomes of a randomized community-level HIV prevention intervention for women living in 18 low-income housing developments.}, Journal = {American Journal of Public Health}, Volume = {90}, Number = {1}, Pages = {57-63}, Year = {2000}, Month = {January}, ISSN = {0090-0036}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10630138}, Keywords = {Adult • Condoms • Female • HIV Infections • Health Knowledge, Attitudes, Practice • Humans • Likelihood Functions • Linear Models • Outcome Assessment (Health Care) • Poverty* • Public Housing* • Risk-Taking • Sexual Behavior • Sexual Partners • United States • Women's Health Services* • prevention & control* • utilization}, Abstract = {OBJECTIVES:Women in impoverished inner-city neighborhoods are at high risk for contracting HIV. A randomized, multisite community-level HIV prevention trial was undertaken with women living in 18 low-income housing developments in 5 US cities. METHODS:Baseline and 12-month follow-up population risk characteristics were assessed by surveying 690 women at both time points. In the 9 intervention condition housing developments, a community-level intervention was undertaken that included HIV risk reduction workshops and community HIV prevention events implemented by women who were popular opinion leaders among their peers. RESULTS:The proportion of women in the intervention developments who had any unprotected intercourse in the past 2 months declined from 50% to 37.6%, and the percentage of women's acts of intercourse protected by condoms increased from 30.2% to 47.2%. Among women exposed to intervention activities, the mean frequency of unprotected acts of intercourse in the past 2 months tended to be lower at follow-up (mean = 4.0) than at baseline (mean = 6.0). These changes were corroborated by changes in other risk indicators. CONCLUSIONS:Community-level interventions that involve and engage women in neighborhood-based HIV prevention activities can bring about reductions in high-risk sexual behaviors.}, Language = {eng}, Doi = {10.2105/ajph.90.1.57}, Key = {fds253986} } @article{fds253898, Author = {Sikkema, KJ and Wagner, LI and Bogart, LM}, Title = {Gender and cultural factors in the prevention of HIV infection among women}, Pages = {299-319}, Booktitle = {Handbook of Gender, Culture, and Health}, Publisher = {Lawrence Eribaum and Associates, Inc.}, Editor = {Eisler, RM and Hersen, M}, Year = {2000}, Key = {fds253898} } @article{fds253984, Author = {Heckman, TG and Kochman, A and Sikkema, KJ and Kalichman, SC}, Title = {Depressive symptomatology, daily stressors, and ways of coping among middle-age and older adults living with HIV disease}, Journal = {Journal of Mental Health and Aging}, Volume = {5}, Number = {4}, Pages = {311-322}, Year = {1999}, Month = {December}, Abstract = {New cases of HIV infection are rapidly escalating among middle-age and older adults, and older persons with AIDS are living longer than ever before. However, because the vast majority of AIDS mental health research has focused on younger persons, health science researchers know little about stressors that affect HIV-infected older adults, their coping efforts employed to resolve these stressors, and whether the presence of psychological distress alters their coping responses. The current study surveyed 113 midlife and older adults (M age = 53.4 years) living with HIV/AIDS in New York City and Milwaukee, Wisconsin, and assessed levels of depressive symptomatology, daily stressors, and the relationship between coping and depression. Approximately 29% of participants reported 'moderate' or 'severe' levels of depression as assessed by the Beck Depression Inventory. HIV-infected older adults with elevated levels of depression experienced more stress due to poor finances, lack of HIV-related information and support resources, and AIDS-related stigma and discrimination. When attempting to resolve significant stressors, depressed older persons more often distanced themselves from the stressor, used more escape-avoidant coping, and less frequently found something positive in the stressful situation. As AIDS affects more people of all ages, mental health interventions that enhance the coping abilities of older persons with HIV/AIDS - especially those with elevated levels of psychological distress - are urgently needed.}, Key = {fds253984} } @article{fds253911, Author = {Heckman, TG and Kalichman, SC and Roffman, RR and Sikkema, KJ and Davantes Heckman and B and Somlai, AM and Walker, J}, Title = {A telephone-delivered coping improvement intervention for persons living with hiv/aids in rural areas}, Journal = {Social Work With Groups}, Volume = {21}, Number = {4}, Pages = {49-61}, Publisher = {Informa UK Limited}, Year = {1999}, Month = {May}, ISSN = {0160-9513}, url = {http://dx.doi.org/10.1300/J009v21n04_05}, Abstract = {People living with HIV disease in small towns and rural areas often experience elevated perceptions of loneliness, lack access to mental health services, and engage in maladaptive illness-related coping strategies. It may be possible, however, to improve the life quality and coping capacities of HIV-infected rural residents through telephone-delivered, coping improvement interventions. The current article describes a telephone-delivered, coping improvement group intervention for HIV-infected rural residents based on a widely accepted cognitive-behavioral model of coping. An eight-session coping intervention is outlined and recommendations intended to increase the intervention’sinterventions that address the emotional and psychological needs of HIV-infected rural residents are increasingly needed. © 1999, Taylor & Francis Group, LLC. All rights reserved.}, Doi = {10.1300/J009v21n04_05}, Key = {fds253911} } @article{fds253899, Author = {Sikkema, KJ and Kelly, JA and Holtgrave, DR}, Title = {Community outreach and education}, Pages = {1323-1328}, Booktitle = {Sexually Transmitted Diseases}, Publisher = {The McGraw-Hill Companies}, Editor = {Holmes, KK and Sparling, PF and Mardh, PA and Lemon, SM and Stamm, WE and Pilot, P and Wasserheit, JN}, Year = {1999}, Key = {fds253899} } @article{fds253982, Author = {McAuliffe, TL and Kelly, JA and Sikkema, KJ and Murphy, DA and Winett, RA and Solomon, LJ and Roffman, RA}, Title = {Sexual HIV risk behavior levels among young and older gay men outside of AIDS epicenters: Findings of a 16-city sample}, Journal = {Aids and Behavior}, Volume = {3}, Number = {2}, Pages = {111-119}, Year = {1999}, ISSN = {1090-7165}, url = {http://dx.doi.org/10.1023/A:1025431822394}, Abstract = {Although AIDS rates have leveled among older gay men in large original epicenters, HIV seroincidence remains high among young men who have sex with men (MSM) in many areas of the country. This research examined patterns of risk behavior among young (age 25 years or less) and older (age 26 years and over) MSM. Nearly 2,000 men entering gay bars in 16 small U.S. cities completed an anonymous survey of their sexual practices in the past 2 months and of psychosocial risk-related characteristics. Young men were more likely than older men to have engaged in unprotected anal intercourse and, specifically, receptive intercourse in the past 2 months. Younger men also reported more frequent occurrences of unprotected anal intercourse. A progressive decline in risk behavior levels was associated with increasing age. Young men less often personally knew someone who had died of AIDS, and deaths were not primarily within their close social networks. Continued HIV prevention efforts directed toward young MSM are needed, including cities traditionally considered as second tier with respect to AIDS.}, Doi = {10.1023/A:1025431822394}, Key = {fds253982} } @article{fds253983, Author = {DiFranceisco, W and Kelly, JA and Sikkema, KJ and Somlai, AM and Murphy, DA and Stevenson, LY}, Title = {Differences between completers and early dropouts from 2 HIV intervention trials: a health belief approach to understanding prevention program attrition.}, Journal = {American Journal of Public Health}, Volume = {88}, Number = {7}, Pages = {1068-1073}, Year = {1998}, Month = {July}, ISSN = {0090-0036}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9663156}, Keywords = {Adult • Age Factors • Analysis of Variance • Attitude to Health* • Bisexuality • Female • HIV Infections • Homosexuality, Male • Humans • Logistic Models • Male • Mental Disorders • Patient Dropouts • Risk-Taking • Sexual Behavior • prevention & control* • psychology • psychology* • statistics & numerical data}, Abstract = {OBJECTIVES:The purpose of this study was to identify factors predicting program attrition among participants in human immunodeficiency virus (HIV) risk reduction trials. METHODS:Participants were gay/bisexual men and severely mentally ill adults recruited to take part in HIV risk reduction small-group interventions. Program completers were compared with participants who were assessed at baseline but then failed to attend any sessions. The health belief model provided a framework for selection of possible predictors of program attrition. RESULTS:Younger age was associated with early dropout in both samples. Other predictors among gay/bisexual men included involvement in an exclusive sexual relationship, minority ethnicity, injection drug use, and higher perceived severity of AIDS. Severely mentally ill dropouts were less knowledgeable about safer sex methods and more likely to hold positive outcome expectancies for condom use. CONCLUSIONS:Evaluation of intervention effectiveness among vulnerable population segments is threatened if there is selective attrition. Better methods are needed to attract and maintain participation in HIV prevention programs. Alternatively, wider application of "intention to treat" analysis of intervention outcomes is recommended to minimize selection bias due to program dropout.}, Language = {eng}, Doi = {10.2105/ajph.88.7.1068}, Key = {fds253983} } @article{fds254037, Author = {Kelly, JA and Otto-Salaj, LL and Sikkema, KJ and Pinkerton, SD and Bloom, FR}, Title = {Implications of HIV treatment advances for behavioral research on AIDS: protease inhibitors and new challenges in HIV secondary prevention.}, Journal = {Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association}, Volume = {17}, Number = {4}, Pages = {310-319}, Year = {1998}, Month = {July}, ISSN = {0278-6133}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9697940}, Keywords = {Acquired Immunodeficiency Syndrome • Anti-HIV Agents • Drug Therapy, Combination • HIV Infections • HIV Long-Term Survivors • HIV Protease Inhibitors • Health Behavior* • Health Knowledge, Attitudes, Practice • Humans • Patient Care Team • Patient Compliance • drug therapy* • prevention & control • psychology • psychology* • therapeutic use*}, Abstract = {Protease inhibitor combination therapies can reduce HIV viral load, improve immune system functioning, and decrease mortality from AIDS. These medical developments raise a host of critical new issues for behavioral research on HIV/AIDS. This article reviews developments in HIV combination therapy regimens and behavioral factors involved in these regimens and focuses on four key behavioral research areas: (a) the development of interventions to promote treatment adherence, (b) psychological coping with HIV/AIDS in the context of new treatments for the disease, (c) the possible influence of treatment on continued risk behavior, and (d) behavioral research in HIV prevention and care policy areas. Advances in HIV medical care have created important new opportunities for health psychologists to contribute to the well-being of persons with HIV/AIDS.}, Language = {eng}, Doi = {10.1037//0278-6133.17.4.310}, Key = {fds254037} } @article{fds253981, Author = {Celentano, DD and Dilorio, C and Hartwell, T and Kelly, J and Magana, R and Maibach, E and O'Leary, A and Pequegnat, W and Rotheram-Borus, MJ and Schilling, R and Amsel, J and El-Bassel, N and Ferreira-Pinto, JB and Gleghorn, A and Ivanoff, A and Barton, J and Martin, R and Miller, S and Murphy, D and Raffaelli, M and Rompalo, AM and Schlenger, W and Sikkema, K and Somial, A and Alford, K and Allende-Ramos, C and Hackl, K and Kuklinsky, M and Lopez, E and Nava, P and Parra, M and Pranke, J and Reid, H and Sharpe-Potter, J and Villasenor, Y and Hansen, N and LaVange, L and McFadden, D and Perritt, R et al.}, Title = {The NIMH Multisite HIV Prevention Trial: reducing HIV sexual risk behavior. The National Institute of Mental Health (NIMH) Multisite HIV Prevention Trial Group.}, Journal = {Science (New York, N.Y.)}, Volume = {280}, Number = {5371}, Pages = {1889-1894}, Year = {1998}, Month = {June}, ISSN = {0036-8075}, url = {http://dx.doi.org/10.1126/science.280.5371.1889}, Abstract = {The efficacy of a behavioral intervention to reduce human immunodeficiency virus (HIV) risk behaviors was tested in a randomized, controlled trial with three high-risk populations at 37 clinics from seven sites across the United States. Compared with the 1855 individuals in the control condition, the 1851 participants assigned to a small-group, seven-session HIV risk reduction program reported fewer unprotected sexual acts, had higher levels of condom use, and were more likely to use condoms consistently over a 12-month follow-up period. On the basis of clinical record review, no difference in overall sexually transmitted disease (STD) reinfection rate was found between intervention and control condition participants. However, among men recruited from STD clinics, those assigned to the intervention condition had a gonorrhea incidence rate one-half that of those in the control condition. Intervention condition participants also reported fewer STD symptoms over the 12-month follow-up period. Study outcomes suggest that behavioral interventions can reduce HIV-related sexual risk behavior among low-income women and men served in public health settings. Studies that test strategies for reducing sexual risk behavior over longer periods of time are needed, especially with populations that remain most vulnerable to HIV infection.}, Doi = {10.1126/science.280.5371.1889}, Key = {fds253981} } @article{fds90808, Author = {KJ Sikkema and TG Heckman and JA Kelly}, Title = {HIV risk behaviors among inner-city African American women. The Community Housing AIDS Prevention Study Group.}, Journal = {Women's health (Hillsdale, N.J.)}, Volume = {3}, Number = {3-4}, Pages = {349-66}, Year = {1998}, Month = {February}, ISSN = {1077-2928}, url = {http://dx.doi.org/10.1080/09540120020018233}, Keywords = {Adolescent • Adult • African Americans* • Aged • Aged, 80 and over • Analysis of Variance • Chi-Square Distribution • Confidence Intervals • Cross-Sectional Studies • Female • HIV Infections* • Health Knowledge, Attitudes, Practice* • Health Surveys • Humans • Logistic Models • Middle Aged • Odds Ratio • Poverty • Public Housing • Risk-Taking* • Sampling Studies • United States • Urban Health* • Women's Health* • epidemiology • ethnology • psychology • statistics & numerical data • statistics & numerical data*}, Abstract = {This study examined the prevalence and predictors of HIV risk behaviors among a sample of 875 low-income, African American women residents of inner-city housing developments. The women completed an anonymous questionnaire that revealed that one third of them were at high risk for HIV either because they had multiple partners or because of the high-risk behaviors of their regular partner. HIV risk was highest among women who accurately perceived themselves to be at increased HIV risk, reported weak behavioral intentions to reduce risk, and held stronger beliefs about psychosocial barriers to condom use. Women at high risk were also younger, reported higher rates of substance use, and indicated that their housing development lacked social cohesiveness. These findings suggest that HIV prevention efforts for this population should focus on strengthening women's risk reduction behavioral intentions and self-efficacy through skill development, overcoming psychosocial barriers to condom use, managing the risk related to substance use, and incorporating approaches that take into account the social, psychological, and relationship barriers to change among economically impoverished African American women.}, Language = {eng}, Doi = {10.1080/09540120020018233}, Key = {fds90808} } @article{fds253980, Author = {DiFranceisco, W and McAuliffe, TL and Sikkema, KJ}, Title = {Influences of survey instrument format and social desirability on the reliability of self-reported high risk sexual behavior}, Journal = {Aids and Behavior}, Volume = {2}, Number = {4}, Pages = {329-337}, Year = {1998}, Month = {January}, Abstract = {This study examined instrument-related and respondent-related self- presentation effects on the reliability of HIV sexual risk self-reports. Sixty-five men who have sex with men (MSM) were randomly assigned to assessment conditions differing only on the format for questions about their sexual behavior. For Group 1, the instrument tested responses to items directly addressing the issue of unsafe sex; men reported absolute frequencies of sexual activities engaged in 'with' and 'without a condom.' For Group 2, questions were framed more positively with respect to condom use; participants were instructed to report total number of intercourse occasions, and then indicate on a scale the relative frequency (percentage) of times 'condoms were used.' It was anticipated that Group i participants would feel more inhibited about reporting episodes of unprotected sex, particularly unprotected anal intercourse (UAI). The Marlowe-Crowne scale was used to control for general tendencies toward socially desirable responding within the sample. Results confirmed that men in Group 1 tended to report lower rates (percents) of UAI, and that, among participants with higher frequencies of anal intercourse, this difference was statistically significant. Weighted least squares regression analysis showed that hypothesized indicators of measurement error - assessment group and social desirability - together accounted for more than half of the explained variance in percent UAI. The findings suggest that HIV prevention researchers need to give higher priority to methodological issues involved in the data collection process. Also, more research is needed on the implications of socially desirable responding for the reliability of self-reports of HIV sexual risk behavior.}, Key = {fds253980} } @article{fds253900, Author = {Sikkema, KJ}, Title = {HIV risk reduction for women}, Pages = {198-202}, Booktitle = {Behavioral Medicine and Women: A Comprehensive Handbook}, Publisher = {Guilford Press}, Editor = {Blechman, EA and Brownell, KD}, Year = {1998}, Key = {fds253900} } @article{fds254036, Author = {Somlai, AM and Kelly, JA and McAuliffe, TL and Gudmundson, JL and Murphy, DA and Sikkema, KJ and Hackl, KL}, Title = {Role play assessments of sexual assertiveness skills: Relationships with HIV/AIDS sexual risk behavior practices}, Journal = {AIDS and Behavior}, Volume = {2}, Number = {4}, Pages = {319-328}, Year = {1998}, Abstract = {Conceptual formulations of HIV risk reduction and many HIV prevention interventions reported in the literature emphasize the role of sexual assertiveness, negotiation, and communication skills as key elements for enacting behavior change. However, there have been few attempts to determine if objective ratings of individuals' sexual communication skill effectiveness are actually associated with their levels of HIV sexual risk behavior. In the current study, 114 severely mentally ill men and women role-played scenes in which confederates simulated attempts to coerce unprotected sex. Participants' role-played responses were transcribed verbatim and later rated for quality in several areas of assertiveness skill effectiveness. In addition, participants provided detailed information concerning their sexual behavior practices in the past 30 days. Participants were categorized into highly, intermediately, or poorly skilled groups based on effectiveness in role play performance, and the groups were then compared on indices of HIV risk behavior. Individuals with high objectively rated sexual assertiveness skill had the lowest number of unprotected sex acts, the smallest number of different sexual partners, the smallest number of casual sex partners, and the highest levels of condom-protected sex in the past 30 days. Individuals with poor sexual assertiveness role-play skills had the highest levels of sexual risk behavior. These associations were especially pronounced among women. Findings of this research provide support for teaching individuals to develop and refine their sexual assertiveness and communication skills in HIV prevention programs. Future research issues in this area are highlighted.}, Key = {fds254036} } @article{fds253966, Author = {Kelly, JA and Murphy, DA and Sikkema, KJ and McAuliffe, TL and Roffman, RA and Solomon, LJ and Winett, RA and Kalichman, SC}, Title = {Randomised, controlled, community-level HIV-prevention intervention for sexual-risk behaviour among homosexual men in US cities. Community HIV Prevention Research Collaborative.}, Journal = {Lancet (London, England)}, Volume = {350}, Number = {9090}, Pages = {1500-1505}, Year = {1997}, Month = {November}, ISSN = {0140-6736}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9388397}, Keywords = {Adult • HIV Infections • Health Education • Homosexuality, Male* • Humans • Intervention Studies • Male • Questionnaires • Risk-Taking • Sexual Behavior* • United States • methods* • prevention & control*}, Abstract = {BACKGROUND:Community-level interventions may be helpful in population-focused HIV prevention. If members of populations at risk of HIV infection who are popular with other members can be engaged to advocate the benefits of behaviour change to peers, decreases in risk behaviour may be possible. We assessed a community-level intervention to lower the risk of HIV infection, focusing on men patronising gay bars in eight small US cities. METHODS:We used a randomised community-level field design. Four cities received the intervention and four control cities did not. Participants were men from each city who went to gay bars. Men completed surveys about their sexual behaviour on entering the bars during 3-night periods at baseline and at 1-year follow-up. In the control cities, HIV educational materials were placed in the bars. In the intervention cities, we recruited popular homosexual men in the community and trained them to spread behaviour-change endorsements and recommendations to their peers through conversation. FINDINGS:Population-level of risk behaviour decreased significantly in the intervention cities compared with the control cities at 1-year follow-up, after exclusion of surveys completed by transients and men with exclusive sexual partners in a city-level analysis, in the intervention cities we found a reduction in the mean frequency of unprotected anal intercourse during the previous 2 months (baseline 1.68 occasions; follow-up 0.59: p = 0.04) and an increase in the mean percentage of occasions of anal intercourse protected by condoms (baseline 44.7%; follow-up 66.8%, p = 0.02). Increased numbers of condoms taken from dispensers in intervention-city bars corroborated risk-behaviour self-reports. INTERPRETATION:Popular and well-liked members of a community who systematically endorse and recommend risk-reduction behaviour can influence the sexual-risk practices of others in their social networks. Natural styles of communication, such as conversations, brought about population-level changes in risk behaviour.}, Language = {eng}, Doi = {10.1016/s0140-6736(97)07439-4}, Key = {fds253966} } @article{fds254034, Author = {Kelly, JA and McAuliffe, TL and Sikkema, KJ and Murphy, DA and Somlai, AM and Mulry, G and Miller, JG and Stevenson, LY and Fernandez, MI}, Title = {Reduction in risk behavior among adults with severe mental illness who learned to advocate for HIV prevention.}, Journal = {Psychiatric Services (Washington, D.C.)}, Volume = {48}, Number = {10}, Pages = {1283-1288}, Year = {1997}, Month = {October}, ISSN = {1075-2730}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9323747}, Keywords = {Adult • Chronic Disease • Cognitive Therapy • Female • HIV Infections • Health Behavior* • Health Knowledge, Attitudes, Practice* • Humans • Male • Mental Disorders • Patient Advocacy* • Psychotherapy, Group • Sex Education • Social Values • Wisconsin • prevention & control* • psychology • rehabilitation* • transmission}, Abstract = {OBJECTIVES: The study evaluated the relative impact of HIV risk reduction interventions for adults with severe mental illness living in the inner city. METHODS: A total of 104 chronically mentally ill men and women were interviewed to determine sexual risk behavior over the past month and to assess HIV risk-related psychological characteristics, including their knowledge about risk behavior, their belief in their ability to change their behavior, their perceptions of peer and social norms about safer sex, their expectancies about the outcomes of these changes, and their perceived barriers to condom use. Participants were then randomly assigned to one of three conditions: a single AIDS education session, a seven-session cognitive-behavioral HIV risk reduction group intervention, or a seven-session group intervention that combined the cognitive-behavioral intervention with training to act as a risk reduction advocate to friends (advocacy training). Individuals were reinterviewed three months after completion of the intervention. RESULTS: Although all participants exhibited change at follow-up in some risk-related psychological characteristics and sexual risk behaviors, participants who received the cognitive-behavioral intervention that included the advocacy training reported greater reductions in rates of unprotected sex and had fewer sexual partners at follow-up. CONCLUSIONS: HIV prevention interventions that teach risk reduction skills and then encourage participants to advocate behavior change to others appear to strengthen participants' capacity to change their behavior to reduce HIV risk, even those from a disenfranchised group such as severely mentally ill adults.}, Language = {eng}, Doi = {10.1176/ps.48.10.1283}, Key = {fds254034} } @article{fds253965, Author = {Heckman, TG and Somlai, AM and Sikkema, KJ and Kelly, JA and Franzoi, SL}, Title = {Psychosocial predictors of life satisfaction among persons living with HIV infection and AIDS.}, Journal = {The Journal of the Association of Nurses in Aids Care : Janac}, Volume = {8}, Number = {5}, Pages = {21-30}, Year = {1997}, Month = {September}, ISSN = {1055-3290}, url = {http://www.ncbi.nlm.nih.gov/pubmed/9298467}, Abstract = {As AIDS becomes a more chronic but manageable illness, understanding quality of life issues among persons living with this disease has become an important goal of health care researchers. However, most quality of life investigations of persons living with HIV disease have relied heavily on clinical samples (e.g., hospitalized patients, psychiatric outpatients). The present study sought to identify psychosocial predictors of general life satisfaction in a community sample of 275 persons living with HIV/AIDS in a large midwestern state. Principal components and multiple regression analyses revealed that improved physical/functional well-being, increased social support, more frequent use of active coping strategies, and fewer incidents of AIDS-related discrimination and stigma predicted higher levels of general life satisfaction (R2 = 39). Intervention strategies likely to produce higher levels of life satisfaction among persons living with HIV disease are discussed.}, Doi = {10.1016/s1055-3290(97)80026-x}, Key = {fds253965} } @article{fds254032, Author = {Sikkema, KJ and Bissett, RT}, Title = {Concepts, goals, and techniques of counseling: Review and implications for HIV counseling and testing}, Journal = {Aids Education and Prevention : Official Publication of the International Society for Aids Education}, Volume = {9}, Number = {3 SUPPL.}, Pages = {14-26}, Year = {1997}, Month = {June}, ISSN = {0899-9546}, url = {http://dx.doi.org/10.1080/09540120020018233}, Keywords = {AIDS Serodiagnosis* • Acquired Immunodeficiency Syndrome • Cognitive Therapy • Counseling • Goals • Health Education • Health Knowledge, Attitudes, Practice • Humans • Treatment Outcome • methods* • prevention & control* • psychology • transmission}, Abstract = {Research to examine, understand, and improve the usefulness and effectiveness of HIV counseling and testing (HIV CT) has been challenging, to some extent because of a less than fully articulated conceptual framework. The goal of this article is to place HIV CT in a conceptual and theoretical context, not only of counseling and psychotherapy but also of a larger framework of models of behavior change. Counseling approaches are also compared with respect to how well they address five tasks of HIV counseling: relationship building, risk assessment, dissemination of information, behavior change, and emotional and coping support. No single counseling approach was found to meet all of these tasks. Behavioral and cognitive-behavioral approaches were considered most relevant to the tasks of HIV counseling, whereas client-centered and crisis counseling approaches were appropriate for the relationship building and emotional/coping support components of HIV counseling. In addition, this article provides a more differentiated view of HIV CT and suggests how further research into the effectiveness of HIV counseling can be informed by primary underlying counseling theories.}, Language = {eng}, Doi = {10.1080/09540120020018233}, Key = {fds254032} } @article{fds90814, Author = {TG Heckman and KJ Sikkema and JA Kelly and RW Fuqua and MB Mercer and RG Hoffmann, RA Winett and ES Anderson and MJ Perry and RA Roffman and LJ Solomon, DA Wagstaff and V Cargill and AD Norman and D Crumble}, Title = {Predictors of condom use and human immunodeficiency virus test seeking among women living in inner-city public housing developments.}, Journal = {Sexually transmitted diseases}, Volume = {23}, Number = {5}, Pages = {357-65}, Year = {1997}, Month = {January}, ISSN = {0148-5717}, url = {http://dx.doi.org/10.1080/09540129650125542}, Keywords = {Americas • Barrier Methods • Behavior • Condom* • Contraception • Contraceptive Methods • Demographic Factors • Developed Countries • Diseases • Economic Factors • Family Planning • Hiv Infections--women* • Low Income Population--women* • Multiple Partners* • North America • Northern America • Population • Population Characteristics • Research Methodology • Research Report* • Retrospective Studies* • Risk Reduction Behavior* • Sex Behavior • Sexual Partners • Social Class • Socioeconomic Factors • Socioeconomic Status • Studies • United States • Urban Population--women* • Viral Diseases}, Abstract = {OBJECTIVE: To examine prevalence and predictors of condom use and human immunodeficiency virus (HIV) test seeking among women living in inner-city housing developments. METHODS: Between April and June 1994, 671 women living in low-income housing developments in five cities in the United States completed an anonymous self-report questionnaire eliciting information on acquired immune deficiency syndrome (AIDS) risk behavior and characteristics indicative of risk. RESULTS: Most participants were women of color who were economically disadvantaged. Fifteen percent reported multiple sex partners, and 30% of women with one sex partner believed he had sex with someone else in the past year. Predictors of condom use included increased rates of safe-sex negotiation, stronger risk reduction intentions, absence of condom barrier beliefs, and multiple sex partners. Women tested for HIV in the past year were younger, perceived themselves to be at risk for HIV infection, reported more conversations with other women about AIDS concerns, and had condoms readily available. CONCLUSIONS: HIV public health prevention interventions are urgently needed for women who live in low-income urban housing developments.}, Language = {eng}, Doi = {10.1080/09540129650125542}, Key = {fds90814} } @article{fds253912, Author = {Sikkema (NIMH Multisite) and KJ}, Title = {Methodological overview of a NIMH multisite HIV prevention trial for populations at risk for HIV}, Journal = {Aids}, Volume = {11}, Pages = {1-11}, Year = {1997}, Abstract = {Supplement 2}, Key = {fds253912} } @article{fds253913, Author = {Sikkema (NIMH Multisite) and KJ}, Title = {Screening, recruiting, and predicting retention of participants in a multisite HIV prevention trial}, Journal = {Aids}, Volume = {11}, Pages = {13-19}, Year = {1997}, Abstract = {Supplement 2}, Key = {fds253913} } @article{fds253914, Author = {Sikkema (NIMH Multisite) and KJ}, Title = {Demographic and behavioral predictors of sexual risk in a NIMH multisite HIV prevention trial}, Journal = {Aids}, Volume = {11}, Pages = {21-27}, Year = {1997}, Abstract = {Supplement 2}, Key = {fds253914} } @article{fds253915, Author = {Sikkema (NIMH Multisite) and KJ}, Title = {Conceptual basis and procedures for the intervention in a multisite HIV prevention trial}, Journal = {Aids}, Volume = {11}, Pages = {29-35}, Year = {1997}, Abstract = {Supplement 2}, Key = {fds253915} } @article{fds253916, Author = {Sikkema (NIMH Multisite) and KJ}, Title = {Endpoints and other measures in a NIMH multisite HIV prevention trial}, Journal = {Aids}, Volume = {11}, Pages = {37-47}, Year = {1997}, Abstract = {Supplement 2}, Key = {fds253916} } @article{fds253917, Author = {Sikkema (NIMH Multisite) and KJ}, Title = {Quality control and quality assurance in HIV prevention research: Model from the NIMH Multisite HIV Prevention Trial}, Journal = {Aids}, Volume = {11}, Pages = {49-53}, Year = {1997}, Abstract = {Supplement 2}, Key = {fds253917} } @article{fds253918, Author = {Sikkema (NIMH Multisite) and KJ}, Title = {Definitions of adverse reactions in clinical trials of a behavioral intervention}, Journal = {Aids}, Volume = {11}, Pages = {55-57}, Year = {1997}, Abstract = {Supplement 2}, Key = {fds253918} } @article{fds253919, Author = {Sikkema, KJ}, Title = {Collecting sexually transmitted disease clinic chart data in multisite studies}, Journal = {Aids}, Volume = {11}, Pages = {59-63}, Year = {1997}, Abstract = {Supplement 2}, Key = {fds253919} } @article{fds254035, Author = {Sikkema, KJ and Heckman, TG and Kelly, JA}, Title = {HIV risk behaviors among inner-city African American women.}, Journal = {Women'S Health (Hillsdale, N.J.)}, Volume = {3}, Pages = {349-366}, Year = {1997}, ISSN = {1077-2928}, Abstract = {This study examined the prevalence and predictors of HIV risk behaviors among a sample of 875 low-income, African American women residents of inner-city housing developments. The women completed an anonymous questionnaire that revealed that one third of them were at high risk for HIV either because they had multiple partners or because of the high-risk behaviors of their regular partner. HIV risk was highest among women who accurately perceived themselves to be at increased HIV risk, reported weak behavioral intentions to reduce risk, and held stronger beliefs about psychosocial barriers to condom use. Women at high risk were also younger, reported higher rates of substance use, and indicated that their housing development lacked social cohesiveness. These findings suggest that HIV prevention efforts for this population should focus on strengthening women's risk reduction behavioral intentions and self-efficacy through skill development, overcoming psychosocial barriers to condom use, managing the risk related to substance use, and incorporating approaches that take into account the social, psychological, and relationship barriers to change among economically impoverished African American women.}, Key = {fds254035} } @article{fds90823, Author = {TG Heckman and JA Kelly and RA Roffman and KJ Sikkema and MJ Perry and LJ Solomon, RA Winett and AD Norman and RG Hoffmann and LY Stevenson}, Title = {Psychosocial differences between recently HIV tested and non-tested gay men who reside in smaller US cities.}, Journal = {International journal of STD & AIDS}, Volume = {6}, Number = {6}, Pages = {436-40}, Year = {1996}, Month = {October}, ISSN = {0956-4624}, url = {http://dx.doi.org/10.1007/BF02903938}, Keywords = {AIDS Serodiagnosis • Adult • Bisexuality* • Condoms • Homosexuality, Male* • Humans • Male • Risk-Taking • Sexual Behavior • Sexual Partners • Social Behavior • Urban Population • psychology*}, Abstract = {While a number of studies have examined behavioural and psychosocial correlates of HIV test seeking, most of this research has relied on samples of urban gay men. Less is known about HIV testing rates and factors associated with testing among gay and bisexual men who live in smaller cities. The present research administered surveys to 3969 non-exclusively partnered gay and bisexual men attending gay bars in small American cities to determine (a) rates of HIV test seeking, and (b) how tested and non-tested men differed on a battery of psychosocial indices. A total of 68% of men had been tested for antibodies to HIV--50% in the past year. Men tested for HIV in the past year, compared to men never tested for HIV, knew more people who were HIV positive or were diagnosed with AIDS, had a closer relationship with someone who had died of AIDS, were more likely to be ethnic minorities, reported more conversations with friends about safer sex, and had stronger intentions to use condoms during their next intercourse occasion. Our results indicate that HIV counselling and testing programmes comprise an important component of HIV prevention efforts assisting gay men residing in smaller USA cities.}, Language = {eng}, Doi = {10.1007/BF02903938}, Key = {fds90823} } @article{fds90834, Author = {SC Kalichman and KJ Sikkema and A Somlai}, Title = {People living with HIV infection who attend and do not attend support groups: a pilot study of needs, characteristics and experiences.}, Journal = {AIDS care}, Volume = {8}, Number = {5}, Pages = {589-99}, Year = {1996}, Month = {October}, ISSN = {0954-0121}, url = {http://dx.doi.org/10.1080/09540129650125542}, Keywords = {Adaptation, Psychological • Adult • Analysis of Variance • Attitude to Health • Chi-Square Distribution • Female • HIV Infections • Humans • Male • Patient Acceptance of Health Care* • Pilot Projects • Retrospective Studies • Sampling Studies • Self-Help Groups* • Social Support • Stress, Psychological • Treatment Outcome • complications • etiology • psychology* • standards • therapy}, Abstract = {People living with Human Immunodeficiency Virus (HIV) confront a myriad of stressors over the course of their infection. Social support groups offer a means of addressing the support needs of people living with HIV. In the present study, 34 persons who had attended HIV support groups and 29 who had not attended groups completed measures of distress, coping, and social connectedness, and participated in open-ended interviews concerning their support group experiences. Results showed that those who attended support groups knew they were HIV-seropositive for a longer time, reported less emotional distress, and had more social contact than did non-attenders. However, non-attenders endorsed avoidant coping strategies to a greater extent. Analyses showed that time since testing positive accounted for differences between groups in social connectedness but not differences in anxiety, depression, or avoidance coping. Thus, HIV-seropositive persons become socially reconnected with time, but individuals with avoidant coping styles experience greater emotional distress and are unlikely to seek support groups. A sizeable proportion of people with HIV may therefore need supportive interventions, particularly nearer to the time that they test HIV-seropositive.}, Language = {eng}, Doi = {10.1080/09540129650125542}, Key = {fds90834} } @article{fds254094, Author = {Kalichman, SC and Sikkema, KJ and Somlai, A}, Title = {People living with HIV infection who attend and do not attend support groups: a pilot study of needs, characteristics and experiences.}, Journal = {Aids Care Psychological and Socio Medical Aspects of Aids/Hiv}, Volume = {8}, Number = {5}, Pages = {589-599}, Year = {1996}, Month = {October}, ISSN = {0954-0121}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8893909}, Keywords = {Adult • Behavior Therapy • Chronic Disease • Combined Modality Therapy • Female • HIV Infections • Health Knowledge, Attitudes, Practice • Humans • Male • Middle Aged • Patient Care Team • Personality Disorders • Psychotherapy, Brief • Psychotic Disorders • Sexual Behavior • Treatment Outcome • complications • methods* • prevention & control* • psychology • rehabilitation* • transmission}, Abstract = {People living with Human Immunodeficiency Virus (HIV) confront a myriad of stressors over the course of their infection. Social support groups offer a means of addressing the support needs of people living with HIV. In the present study, 34 persons who had attended HIV support groups and 29 who had not attended groups completed measures of distress, coping, and social connectedness, and participated in open-ended interviews concerning their support group experiences. Results showed that those who attended support groups knew they were HIV-seropositive for a longer time, reported less emotional distress, and had more social contact than did non-attenders. However, non-attenders endorsed avoidant coping strategies to a greater extent. Analyses showed that time since testing positive accounted for differences between groups in social connectedness but not differences in anxiety, depression, or avoidance coping. Thus, HIV-seropositive persons become socially reconnected with time, but individuals with avoidant coping styles experience greater emotional distress and are unlikely to seek support groups. A sizeable proportion of people with HIV may therefore need supportive interventions, particularly nearer to the time that they test HIV-seropositive.}, Language = {eng}, Doi = {10.1080/09540129650125542}, Key = {fds254094} } @article{fds254033, Author = {Heckman, TG and Sikkema, KJ and Kelly, JA and Fuqua, RW and Mercer, MB and Hoffmann, RG and Winett, RA and Anderson, ES and Perry, MJ and Roffman, RA and Solomon, LJ and Wagstaff, DA and Cargill, V and Norman, AD and Crumble, D}, Title = {Predictors of condom use and human immunodeficiency virus test seeking among women living in inner-city public housing developments.}, Journal = {Sexually Transmitted Diseases}, Volume = {23}, Number = {5}, Pages = {357-365}, Year = {1996}, Month = {September}, ISSN = {0148-5717}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8885065}, Abstract = {BACKGROUND AND OBJECTIVES:To examine prevalence and predictors of condom use and human immunodeficiency virus (HIV) test seeking among women living in inner-city housing developments. STUDY DESIGN:Between April and June 1994, 671 women living in low-income housing developments in five cities in the United States completed an anonymous self-report questionnaire eliciting information on acquired immune deficiency syndrome (AIDS) risk behavior and characteristics indicative of risk. RESULTS:Most participants were women of color who were economically disadvantaged. Fifteen percent reported multiple sex partners, and 30% of women with one sex partner believed he had sex with someone else in the past year. Predictors of condom use included increased rates of safe-sex negotiation, stronger risk reduction intentions, absence of condom barrier beliefs, and multiple sex partners. Women tested for HIV in the past year were younger, perceived themselves to be at risk for HIV infection, reported more conversations with other women about AIDS concerns, and had condoms readily available. CONCLUSIONS:HIV public health prevention interventions are urgently needed for women who live in low-income urban housing developments.}, Doi = {10.1097/00007435-199609000-00003}, Key = {fds254033} } @article{fds90829, Author = {DA Wagstaff and JA Kelly and MJ Perry and KJ Sikkema and LJ Solomon and TG Heckman, ES Anderson}, Title = {Multiple partners, risky partners and HIV risk among low-income urban women.}, Journal = {Family planning perspectives}, Volume = {27}, Number = {6}, Pages = {241-5}, Year = {1996}, Month = {August}, ISSN = {0014-7354}, url = {http://dx.doi.org/10.1007/BF02903938}, Keywords = {Acquired Immunodeficiency Syndrome* • Americas • Attitude* • Barrier Methods • Behavior • Biology • Communication* • Condom* • Contraception • Contraceptive Methods • Contraceptive Usage* • Developed Countries • Diseases • Economic Factors • Family Planning • Hiv Infections* • Interpersonal Relations* • Low Income Population* • North America • Northern America • Psychological Factors • Risk Behavior* • Risk Factors* • Sex Behavior* • Social Class • Socioeconomic Factors • Socioeconomic Status • United States • Viral Diseases}, Abstract = {A sample of 671 predominantly single, young black women living in 10 low-income housing developments in five cities completed an anonymous questionnaire assessing factors related to their risk of contracting the human immunodeficiency virus, including their sexual behavior and condom use, and their partners' risk-related behaviors. In the two months before the 1994 survey, 17% of the women had sex with multiple partners and 22% had an exclusive partner who either had had other sexual partners in the past year or had a history of injection drug use; 40% had an exclusive partner who they believed had not engaged in these risky behaviors. During the same interval, 26% of women who had multiple partners received treatment for a sexually transmitted disease, compared with 9-11% of those who had an exclusive relationship. Condom use at last intercourse and communications about condom use were less frequent among women with an exclusive, risky partner than among those with multiple partners; attitudinal barriers to condom use did not vary, however, by the characteristics of women's relationships.}, Language = {eng}, Doi = {10.1007/BF02903938}, Key = {fds90829} } @article{fds253964, Author = {Sikkema, KJ and Heckman, TG and Kelly, JA and Anderson, ES and Winett, RA and Solomon, LJ and Wagstaff, DA and Roffman, RA and Perry, MJ and Cargill, V and Crumble, DA and Fuqua, RW and Norman, AD and Mercer, MB}, Title = {HIV risk behaviors among women living in low-income, inner-city housing developments.}, Journal = {American Journal of Public Health}, Volume = {86}, Number = {8}, Pages = {1123-1128}, Year = {1996}, Month = {August}, ISSN = {0090-0036}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8712272}, Keywords = {Adolescent • Adult • Aged • Female • HIV Infections • Health Knowledge, Attitudes, Practice • Humans • Middle Aged • Poverty* • Prevalence • Public Housing* • Questionnaires • Risk Factors • Risk-Taking* • Sexual Behavior* • United States • Urban Health* • Women • education • etiology* • prevention & control • psychology*}, Abstract = {OBJECTIVES:This study describes the prevalence and predictors of human immunodeficiency virus (HIV) risk behaviors among women living in low-income, inner-city housing developments. METHODS:Anonymous questionnaires were administered to 671 women living in 10 inner-city, low-income housing developments in five US cities to determine their levels of HIV risk behavior and predictors of HIV risk practices. RESULTS:Approximately one third of women were at high risk for HIV because of the risk behavior of their sexual partners. HIV risk was highest among women who accurately perceived themselves to be at increased HIV risk, held strong beliefs about barriers to condom use, and reported weak behavioral intentions to reduce risk. Women at higher risk were also younger and reported higher rates of alcohol and substance use. CONCLUSIONS:HIV prevention efforts are needed for inner-city women. Interventions should focus on overcoming women's barriers to condom use, strengthening their intentions to change behaviors, and managing the risk related to their use of substances.}, Language = {eng}, Doi = {10.2105/ajph.86.8_pt_1.1123}, Key = {fds253964} } @article{fds254030, Author = {Norman, AD and Perry, MJ and Stevenson, LY and Kelly, JA and Roffman, RA}, Title = {Lesbian and bisexual women in small cities--at risk for HIV? HIV Prevention Community Collaborative.}, Journal = {Public Health Reports (Washington, D.C. : 1974)}, Volume = {111}, Number = {4}, Pages = {347-352}, Year = {1996}, Month = {July}, ISSN = {0033-3549}, Abstract = {Objectives.Women who have sex with women are a relatively hidden group that has been overlooked in most AIDS research and prevention efforts, primarily because the efficiency of HIV transmission between female partners is believed to be low. Although data are scant, it is commonly assumed that members of this population are not at high risk for HIV infection. However, a recent study of lesbian and bisexual women living in the San Francisco Bay area reported a relatively high seroprevalence rate and has raised additional questions about this group's HIV risk. The present study, the first to focus on lesbian and bisexual women living outside major AIDS epicenters, provides additional evidence. It describes risk factors for HIV transmission among lesbian and bisexual women living in small cities in four geographic regions of the United States.Methods.On three consecutive evenings in 1992, members of the research team distributed anonymous structured written surveys to women patrons as they entered gay bars in each of 16 small cities.Results.Almost 17% of bisexual respondents and 0.5% of lesbians reported having had unprotected vaginal or anal sex with a male during the two months prior to the survey. Almost 10 percent of bisexual women and 8.8% of lesbians in the sample reported a history of injection drug use. Among those women surveyed who said they had been tested, 1.4% reported they were infected with HIV.Conclusions.Self-identified sexual orientation was highly consistent with recent sexual behavior. HIV risk related to sexual behavior was concentrated among self-identified bisexual women. The prevalence of injection drug use was substantial among both bisexual and lesbians. Developers of HIV risk behavior programs should take the prevalence of these risk behaviors into consideration in the design of effective HIV prevention interventions tailored to the needs of this hidden population.}, Key = {fds254030} } @article{fds90804, Author = {KJ Sikkema and JJ Koob and VC Cargill and JA Kelly and LL Desiderato and RA Roffman, AD Norman and M Shabazz and C Copeland and RA Winett}, Title = {Levels and predictors of HIV risk behavior among women in low-income public housing developments.}, Journal = {Public health reports (Washington, D.C. : 1974)}, Volume = {110}, Number = {6}, Pages = {707-13}, Year = {1996}, Month = {March}, ISSN = {0033-3549}, url = {http://dx.doi.org/10.1007/BF02903938}, Keywords = {Condoms • Female • HIV Infections • Humans • Male • Poverty* • Public Housing • Risk-Taking* • Sexual Behavior • Sexual Partners • United States • Women's Health • prevention & control* • utilization*}, Abstract = {The prevalence of increases in human immunodeficiency virus infection and illness rates among urban disadvantaged women underscore the urgent need for acquired immunodeficiency syndrome prevention interventions for high-risk women. Few studies, however, have examined the factors contributing to risk in this population or predictors of risk taking and risk reduction. A total of 148 women, most of them of racial minorities, living in low-income public housing developments completed measures designed to assess risk for human immunodeficiency virus infection and to analyze factors related to risk taking, including knowledge about acquired immunodeficiency syndrome, behavior change self-efficacy, intention to use condoms, and social norm perception about safer sex practices. History of sexually transmitted diseases, low rates of condom use, and relationships with men who were injection drug users or who were not sexually exclusive were commonly reported. Women were divided into high- or low-risk categories based on behavior during the two preceding months. Women at low risk believed more strongly in personal efficacy of behavior change, were more committed to using condoms, and perceived risk reduction steps as more socially normative than high-risk women. Culturally tailored human immunodeficiency virus prevention interventions that address these dimensions are needed.}, Language = {eng}, Doi = {10.1007/BF02903938}, Key = {fds90804} } @article{fds254029, Author = {Sikkema, KJ and Kelly, JA}, Title = {Behavioral medicine interventions can improve the quality-of-life and health of persons with HIV disease.}, Journal = {Annals of Behavioral Medicine}, Volume = {18}, Number = {1}, Pages = {40-48}, Year = {1996}, Month = {March}, ISSN = {0883-6612}, url = {http://dx.doi.org/10.1007/bf02903938}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological • Anxiety • Data Collection • Depression • HIV Infections • Humans • Religion and Medicine* • Stress, Psychological • United States • Wisconsin • complications • epidemiology • etiology • physiology* • physiopathology • physiopathology* • psychology*}, Abstract = {Interventions to enhance the quality-of-life and health of persons with human immunodeficiency virus (HIV) disease are becoming increasingly important as the number of people with HIV increases and as medical treatment regimens extend their life expectancy. Behavioral medicine approaches carry considerable promise for the treatment of disorders associated with HIV disease, including HIV-related nutritional disorders, pain management, sleep disorders, and treatment adherence. This article summarizes the literature on the prevalence of these disorders in HIV disease, reviews established behavioral medicine interventions for the disorders, and discusses how behavioral medicine interventions might be applied to the HIV manifestation of the disorders. Efforts to apply behavioral medicine approaches to improve life quality, alleviate sequelae of illness, and improve health outcomes in persons with HIV disease are urgently needed.}, Language = {eng}, Doi = {10.1007/bf02903938}, Key = {fds254029} } @article{fds254031, Author = {Somlai, AM and Kelly, JA and Kalichman, SC and Mulry, G and Sikkema, KJ and McAuliffe, T and Multhauf, K and Davantes, B}, Title = {An empirical investigation of the relationship between spirituality, coping, and emotional distress in people living with HIV infection and AIDS.}, Journal = {Journal of Pastoral Care}, Volume = {50}, Number = {2}, Pages = {181-191}, Year = {1996}, Month = {January}, ISSN = {0022-3409}, url = {http://www.ncbi.nlm.nih.gov/pubmed/10158099}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological • Anxiety • Data Collection • Depression • HIV Infections • Humans • Religion and Medicine* • Stress, Psychological • United States • Wisconsin • complications • epidemiology • etiology • physiology* • physiopathology • physiopathology* • psychology*}, Abstract = {Evaluates levels of psychological distress, coping mechanisms, and their relationship with the religious beliefs and spiritual practices of people (N=65) living with HIV and AIDS. Results of the research indicate a strong relationship for spiritual dimensions with mental health, psychological adjustment, and coping. Concludes that a blending of spiritual traditions and mental health approaches are needed to facilitate the coping of people living with HIV and AIDS.}, Language = {eng}, Doi = {10.1177/002234099605000206}, Key = {fds254031} } @article{fds254025, Author = {Heckman, TG and Kelly, JA and Sikkema, KJ and Roffman, RR and Solomon, LJ and Winett, RA and Stevenson, LY and Perry, MJ and Norman, AD and Desiderato, LJ}, Title = {Differences in HIV risk characteristics between bisexual and exclusively gay men.}, Journal = {Aids Education and Prevention : Official Publication of the International Society for Aids Education}, Volume = {7}, Number = {6}, Pages = {504-512}, Year = {1995}, Month = {December}, ISSN = {0899-9546}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8924347}, Keywords = {Adult • Bisexuality* • Condoms • HIV Infections • Health Knowledge, Attitudes, Practice* • Homosexuality, Male* • Humans • Male • Questionnaires • Risk-Taking • prevention & control* • psychology • statistics & numerical data • utilization}, Abstract = {Research investigating HIV-risk sexual behaviors of men who have sex with men usually combines gay and bisexual men, treating them as a single, homogeneous group. However, gay and bisexual men may differ in their HIV risk behavior and in psychological characteristics indicative of risk. Exclusively gay (N = 1,180) and bisexual men (N = 136) completed anonymous surveys at gay bars. The surveys assessed demographic, psychological, and behavioral data related to sexual behavior and HIV risk. Relative to exclusively gay men, bisexual men had lower intentions to use condoms in their next intercourse occasion, reported a greater frequency of oral sex with men and more oral-sex partners, knew fewer people who were HIV positive, and perceived weaker peer norms favoring safer sex and risk avoidance. One-third of bisexual men reported engaging in unprotected anal intercourse, and 17% of bisexual men had multiple unprotected anal sex partners in the past two months. Interventions tailored to the needs of bisexual men are urgently needed and should focus on increasing intentions to use condoms, increasing HIV-risk sensitization, and fostering norms favoring safer sex and risk avoidance.}, Language = {eng}, Doi = {10.1007/BF02903938}, Key = {fds254025} } @article{fds254023, Author = {Wagstaff, DA and Kelly, JA and Perry, MJ and Sikkema, KJ and Solomon, LJ and Heckman, TG and Anderson, ES}, Title = {Multiple partners, risky partners and HIV risk among low-income urban women.}, Journal = {Family Planning Perspectives}, Volume = {27}, Number = {6}, Pages = {241-245}, Year = {1995}, Month = {November}, ISSN = {0014-7354}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8666088}, Abstract = {A sample of 671 predominantly single, young black women living in 10 low-income housing developments in five cities completed an anonymous questionnaire assessing factors related to their risk of contracting the human immunodeficiency virus, including their sexual behavior and condom use, and their partners' risk-related behaviors. In the two months before the 1994 survey, 17% of the women had sex with multiple partners and 22% had an exclusive partner who either had had other sexual partners in the past year or had a history of injection drug use; 40% had an exclusive partner who they believed had not engaged in these risky behaviors. During the same interval, 26% of women who had multiple partners received treatment for a sexually transmitted disease, compared with 9-11% of those who had an exclusive relationship. Condom use at last intercourse and communications about condom use were less frequent among women with an exclusive, risky partner than among those with multiple partners; attitudinal barriers to condom use did not vary, however, by the characteristics of women's relationships.}, Doi = {10.2307/2136176}, Key = {fds254023} } @article{fds254026, Author = {Heckman, TG and Kelly, JA and Roffman, RA and Sikkema, KJ and Perry, MJ and Solomon, LJ and Winett, RA and Norman, AD and Hoffmann, RG and Stevenson, LY}, Title = {Psychosocial differences between recently HIV tested and non-tested gay men who reside in smaller US cities.}, Journal = {International Journal of Std & Aids}, Volume = {6}, Number = {6}, Pages = {436-440}, Year = {1995}, Month = {November}, ISSN = {0956-4624}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8845403}, Abstract = {While a number of studies have examined behavioural and psychosocial correlates of HIV test seeking, most of this research has relied on samples of urban gay men. Less is known about HIV testing rates and factors associated with testing among gay and bisexual men who live in smaller cities. The present research administered surveys to 3969 non-exclusively partnered gay and bisexual men attending gay bars in small American cities to determine (a) rates of HIV test seeking, and (b) how tested and non-tested men differed on a battery of psychosocial indices. A total of 68% of men had been tested for antibodies to HIV--50% in the past year. Men tested for HIV in the past year, compared to men never tested for HIV, knew more people who were HIV positive or were diagnosed with AIDS, had a closer relationship with someone who had died of AIDS, were more likely to be ethnic minorities, reported more conversations with friends about safer sex, and had stronger intentions to use condoms during their next intercourse occasion. Our results indicate that HIV counselling and testing programmes comprise an important component of HIV prevention efforts assisting gay men residing in smaller USA cities.}, Doi = {10.1177/095646249500600612}, Key = {fds254026} } @article{fds254027, Author = {Sikkema, KJ and Koob, JJ and Cargill, VC and Kelly, JA and Desiderato, LL and Roffman, RA and Norman, AD and Shabazz, M and Copeland, C and Winett, RA}, Title = {Levels and predictors of HIV risk behavior among women in low-income public housing developments.}, Journal = {Public Health Reports (Washington, D.C. : 1974)}, Volume = {110}, Number = {6}, Pages = {707-713}, Year = {1995}, Month = {November}, ISSN = {0033-3549}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8570824}, Abstract = {The prevalence of increases in human immunodeficiency virus infection and illness rates among urban disadvantaged women underscore the urgent need for acquired immunodeficiency syndrome prevention interventions for high-risk women. Few studies, however, have examined the factors contributing to risk in this population or predictors of risk taking and risk reduction. A total of 148 women, most of them of racial minorities, living in low-income public housing developments completed measures designed to assess risk for human immunodeficiency virus infection and to analyze factors related to risk taking, including knowledge about acquired immunodeficiency syndrome, behavior change self-efficacy, intention to use condoms, and social norm perception about safer sex practices. History of sexually transmitted diseases, low rates of condom use, and relationships with men who were injection drug users or who were not sexually exclusive were commonly reported. Women were divided into high- or low-risk categories based on behavior during the two preceding months. Women at low risk believed more strongly in personal efficacy of behavior change, were more committed to using condoms, and perceived risk reduction steps as more socially normative than high-risk women. Culturally tailored human immunodeficiency virus prevention interventions that address these dimensions are needed.}, Key = {fds254027} } @article{fds253979, Author = {Kelly, JA and Murphy, DA and Sikkema, KJ and Somlai, AM and Mulry, GW and Fernandez, MI and Miller, JG and Stevenson, LY}, Title = {Predictors of high and low levels of HIV risk behavior among adults with chronic mental illness.}, Journal = {Psychiatric Services (Washington, D.C.)}, Volume = {46}, Number = {8}, Pages = {813-818}, Year = {1995}, Month = {August}, ISSN = {1075-2730}, url = {http://www.ncbi.nlm.nih.gov/pubmed/7583483}, Keywords = {Adolescent • Adult • Chronic Disease • Female • HIV Infections • Health Behavior* • Health Knowledge, Attitudes, Practice • Homosexuality, Male • Humans • Male • Mental Disorders • Middle Aged • Patient Education as Topic • Sexual Behavior • prevention & control • psychology • psychology* • rehabilitation • transmission*}, Abstract = {OBJECTIVE: Several recent studies confirm elevated rates of human immunodeficiency virus infection among acute and chronic mentally ill adults in large urban areas. This research sought to characterize risk for HIV infection among adults with chronic mental illness and to examine psychosocial factors predictive of risk. METHODS: Two hundred and twenty-five adults with chronic mental illness who were sexually active in the past year outside of exclusive relationships were individually interviewed in community mental health clinics using a structured HIV risk assessment protocol. RESULTS: More than 50 percent of the study participants were sexually active in the past month, and 25 percent had multiple sexual partners during that period. Fifteen percent of the men had male sexual partners. In more than 75 percent of occasions of sexual intercourse, condoms were not used. When participants were categorized as at either high or lower risk for HIV infection based on their pattern of condom use, psychosocial factors that predicted risk level included measures of participants' self-reported efficacy in using condoms, perceptions of social norms related to safer sex among peers and sexual partners, and expectations about outcomes associated with condom use, as well as participants' level of objectively assessed behavioral skills in negotiation and assertiveness in sexual situations. CONCLUSIONS: Interventions aimed at prevention of HIV and AIDS are urgently needed in settings that provide services to persons with chronic mental illness.}, Language = {eng}, Doi = {10.1176/ps.46.8.813}, Key = {fds253979} } @article{fds253978, Author = {Sikkema, KJ and Winett, RA and Lombard, DN}, Title = {Development and evaluation of an HIV-risk reduction program for female college students.}, Journal = {Aids Education and Prevention : Official Publication of the International Society for Aids Education}, Volume = {7}, Number = {2}, Pages = {145-159}, Year = {1995}, Month = {April}, ISSN = {0899-9546}, url = {http://www.ncbi.nlm.nih.gov/pubmed/7619644}, Keywords = {Adolescent • Adult • Assertiveness • Cognitive Therapy • Condoms • Female • Gender Identity* • HIV Infections • Health Education* • Health Knowledge, Attitudes, Practice • Humans • Risk Factors • Role Playing • Sexual Behavior • Treatment Outcome • prevention & control* • psychology • transmission}, Abstract = {College students are engaging in high rates of behavior related to risk of infection from Human Immunodeficiency Virus (HIV) and other sexually transmitted diseases (STDs). A cognitive-behavioral skills training program for heterosexual college females focused on sexual assertiveness skills and the reduction of risk-related behaviors was designed and evaluated compared with an education-only program. Participants completed pre-intervention, post-intervention, and one-month follow-up assessments of: (a) HIV/STD-related knowledge and beliefs; (b) sexual, alcohol, and drug-related behaviors; and (c) sexual assertiveness role-plays. Skills training participants compared to education-only participants scored higher on sexual assertiveness skills, specific knowledge of HIV infection, and self-efficacy to perform lower risk sexual behaviors and reported a reduction in risk-related behaviors at post-intervention and follow-up assessments. The effectiveness of behavioral skills in HIV risk-reduction programs for college students is discussed.}, Language = {eng}, Doi = {10.1007/BF02903938}, Key = {fds253978} } @article{fds287958, Author = {Kalichman, SC and Sikkema, KJ and Kelly, JA and Bulto, M}, Title = {Use of a brief behavioral skills intervention to prevent HIV infection among chronic mentally ill adults.}, Journal = {Psychiatric Services (Washington, D.C.)}, Volume = {46}, Number = {3}, Pages = {275-280}, Year = {1995}, Month = {March}, ISSN = {1075-2730}, url = {http://www.ncbi.nlm.nih.gov/pubmed/7796217}, Abstract = {OBJECTIVE: Research shows that many chronic psychiatric patients are at risk for infection by the human immunodeficiency virus (HIV). This study investigated the effects of a behavioral skills training program designed to prevent HIV infection among chronic mentally ill adults living in an inner-city area. METHODS: Twenty-seven men and 25 women were randomly assigned either to a four-session AIDS prevention program emphasizing risk education, sexual assertiveness, condom use, risk-related behavioral self-management, and problem-solving skills or to a waiting-list group, who later received the same intervention. RESULTS: Compared with the waiting-list control group, participants in the prevention program demonstrated significant gains in AIDS-related knowledge and intentions to change risk behaviors. The prevention program also significantly reduced rates of unprotected sexual intercourse and increased the use of condoms over a one-month follow-up period. A subset of participants who provided two-month follow-up data maintained some behavior changes. CONCLUSIONS: A relatively brief, skills-focused AIDS prevention program for chronic psychiatric patients produced reductions in HIV risk behaviors. Such HIV risk reduction intervention programs may be of use in inpatient, outpatient, and community-based settings.}, Doi = {10.1176/ps.46.3.275}, Key = {fds287958} } @article{fds254024, Author = {Kelly, JA and Sikkema, KJ and Winett, RA and Solomon, LJ and Roffman, RA and Heckman, TG and Stevenson, LY and Perry, MJ and Norman, AD and Desiderato, LJ}, Title = {Factors predicting continued high-risk behavior among gay men in small cities: psychological, behavioral, and demographic characteristics related to unsafe sex.}, Journal = {Journal of Consulting and Clinical Psychology}, Volume = {63}, Number = {1}, Pages = {101-107}, Year = {1995}, Month = {February}, ISSN = {0022-006X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/7896974}, Keywords = {Acquired Immunodeficiency Syndrome • Adult • HIV Seropositivity • Homosexuality, Male • Humans • Male • Prognosis • Risk-Taking • Sexual Behavior* • Urban Population* • prevention & control • psychology* • transmission}, Abstract = {Nearly 6,000 men entering gay bars in 16 small American cities were anonymously surveyed to assess their sexual behavior and to determine predictors of risky sexual practices. Excluding individuals in long-term exclusive relationships, 27% of the men reported engaging in unprotected anal intercourse in the past 2 months. Factors strongly predictive of risk included having a large number of different male partners, estimating oneself to be at greater risk, having weak intentions to use condoms at next intercourse, believing that safer sex is not an expected norm within one's peer reference group, being of younger age, and having less education. These findings indicate that HIV prevention efforts are urgently needed for gay men in smaller cities, with efforts particularly focused on young and less educated men sexually active with multiple partners. Prevention should focus on strengthening intentions to change behavior and on changing social norms to foster safer sex.}, Language = {eng}, Doi = {10.1037//0022-006x.63.1.101}, Key = {fds254024} } @article{fds254084, Author = {Kalichman, SC and Sikkema, KJ and Somlai, A}, Title = {Assessing persons with human immunodeficiency virus (HIV) infection using the Beck Depression Inventory: disease processes and other potential confounds.}, Journal = {Journal of Personality Assessment}, Volume = {64}, Number = {1}, Pages = {86-100}, Year = {1995}, Month = {February}, ISSN = {0022-3891}, url = {http://www.ncbi.nlm.nih.gov/pubmed/7877094}, Keywords = {Confounding Factors (Epidemiology) • Depressive Disorder • Factor Analysis, Statistical • Female • HIV Infections • Humans • Male • Psychological Tests • epidemiology • psychology*}, Abstract = {Symptoms of Human Immunodeficiency Virus (HIV) infection and somatic symptoms of depression overlap, confounding clinical assessments of persons with HIV infection. This research examined the extent of this confounding. In Study 1, 71 persons with HIV infection demonstrated high rates of depression on the Beck Depression Inventory (BDI). However, depression scores correlated with symptoms of HIV infection. In Study 2, 63 persons with HIV infection also demonstrated high rates of depression on the BDI, and depression was again related to symptoms of HIV disease; specifically, persistent fatigue, diarrhea, night sweats, and muscle aches. Principal component factor analyses demonstrated that somatic symptoms of depression were closely associated with number of Acquired Immunodeficiency Syndrome diagnoses, number of HIV-related symptoms, and inversely related to number of T-helper cells. In contrast, cognitive-affective depression was most closely related to anxiety, hypochondriasis, and number of months since tested HIV positive. Results support the conclusion that depression scores require differential interpretations at different stages of HIV disease and that persons who have experienced HIV-related symptoms only be assessed for depression using instruments void of somatic symptoms.}, Language = {eng}, Doi = {10.1207/s15327752jpa6401_5}, Key = {fds254084} } @article{fds253976, Author = {Heckman, TG and Kelly, JA and Sikkema, K and Cargill, V and Norman, A and Fuqua, W and Wagstaff, D and Solomon, L and Roffman, R and Crumble, D and Perry, M and Winett, R and Anderson, E and Mercer, MB and Hoffmann, R}, Title = {HIV risk characteristics of young adult, adult, and older adult women who live in inner-city housing developments: Implications for prevention}, Journal = {Journal of Women'S Health}, Volume = {4}, Number = {4}, Pages = {397-406}, Publisher = {MARY ANN LIEBERT, INC}, Year = {1995}, Month = {January}, url = {http://dx.doi.org/10.1089/jwh.1995.4.397}, Abstract = {Economically disadvantaged urban women are increasingly vulnerable to human immunodeficiency virus (HIV) infection. Research has documented increased HIV risk among urban women, but little attention has focused on the relationship between a woman's age and her HIV risk. The present study surveyed 671 women living in 10 inner-city housing developments in five geographically diverse cities throughout the U.S. It sought to identify factors that place young adult (ages 18-25 years), adult (ages 26-39 years), and older adult (ages 40 and older) women at risk of HIV infection, and to differentiate high HIV-risk young adult, adult, and older women from one another. Multivariate analyses disclosed that women's HIV risk behaviors and characteristics that indicate risk varied by age. Young adult women were at increased risk of HIV infection because they had multiple sexual partners and high-risk partners. Adult and older adult women were at risk primarily because they had high-risk sexual partners. High-risk young adult, adult, and older adult women differed from one another with respect to HIV risk behavior knowledge, beliefs about condom barriers, rates of condom use, perceived risk of HIV infection, and seeking HIV tests. These findings suggest that HIV prevention programs for high-risk, disadvantaged, urban women need to consider the different sexual behavior patterns and life circumstances of young adult, adult, and older adult women.}, Doi = {10.1089/jwh.1995.4.397}, Key = {fds253976} } @article{fds254028, Author = {Winett, RA and Anderson, ES and Desiderato, LL and Solomon, LJ and Perry, M and Kelly, JA and Sikkema, KJ and Roffman, RA and Norman, AD and Lombard, DN and Lombard, TN}, Title = {Enhancing social diffusion theory as a basis for prevention intervention: A conceptual and strategic framework}, Journal = {Applied and Preventive Psychology}, Volume = {4}, Number = {4}, Pages = {233-245}, Publisher = {Elsevier BV}, Year = {1995}, Month = {January}, ISSN = {0962-1849}, url = {http://dx.doi.org/10.1016/S0962-1849(05)80025-3}, Abstract = {Social diffusion theory has recently been recognized as a promising approach for large-scale disease prevention and health promotion efforts. This paper describes how principles and tactics from social cognitive theory, operant psychology, social psychology, social marketing, and the overarching stages of change model can be used to further develop the conceptual and strategic (technological) bases of social diffusion theory. Within an integrative framework, we discuss in detail more effective ways to train peer mediators of behavior change as one example of how social diffusion theory can benefit from this conceptual and strategic reformulation. We then further illustrate the use of peer mediators of change in human immunodeficiency virus (HIV) and cancer prevention intervention studies with both interventions training peer mediators to diffuse information, norms, and risk reduction strategies. Although the results of these studies showed reductions in high-risk behaviors across population segments, more closely following the framework discussed in this article should further increase the behavior change potential of future interventions based on social diffusion theory. © 1995 American Association of Applied and Preventive Psychology (AAAPP).}, Doi = {10.1016/S0962-1849(05)80025-3}, Key = {fds254028} } @article{fds254088, Author = {Roffman, RA and Kalichman, SC and Kelly, JA and Winett, RA and Solomon, LJ and Sikkema, KJ and Norman, AD and Desiderato, LL and Perry, MJ and Lemke, AL}, Title = {HIV antibody testing of gay men in smaller US cities.}, Journal = {Aids Care Psychological and Socio Medical Aspects of Aids/Hiv}, Volume = {7}, Number = {4}, Pages = {405-413}, Year = {1995}, Month = {January}, ISSN = {0954-0121}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8547356}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological • Adolescent • Adolescent Behavior* • Family • Female • Health Education* • Health Promotion • Humans • Male • Parent-Child Relations • Risk-Taking • Videotape Recording* • prevention & control* • psychology • psychology*}, Abstract = {The incidence of new AIDS diagnoses among gay males indicates that risk reduction in smaller communities may be lagging behind that reported in larger cities. Contradictory evidence exists, largely from urban areas, concerning the utility of HIV testing as a means of promoting behavioural change. This study examined the relationship between HIV antibody testing and subsequent high-risk sexual behaviours among gay men in cities of 180,000 or fewer inhabitants. In February and March of 1992, male gay bar patrons in sixteen small US cities were administered an anonymous questionnaire concerning recent sexual behaviour and HIV testing history. Of the 1820 respondents, 28.1% had recently engaged in unprotected anal intercourse and 60.7% had been tested for HIV antibodies. Those who had been tested were more sexually active and reported more protected and safer sexual activities. Analyses at the individual and city levels converged to demonstrate that communities as well as individuals evidence increased self-protection in association with HIV antibody testing.}, Language = {eng}, Doi = {10.1080/09540129550126362}, Key = {fds254088} } @article{fds254089, Author = {Sikkema, KJ and Kalichman, SC and Kelly, JA and Koob, JJ}, Title = {Group intervention to improve coping with AIDS-related bereavement: model development and an illustrative clinical example.}, Journal = {Aids Care Psychological and Socio Medical Aspects of Aids/Hiv}, Volume = {7}, Number = {4}, Pages = {463-475}, Year = {1995}, Month = {January}, ISSN = {0954-0121}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8547361}, Keywords = {Acquired Immunodeficiency Syndrome • Adaptation, Psychological • Adult • Bereavement* • Cognitive Therapy • Emotions • Female • Goals • Humans • Male • Middle Aged • Models, Psychological* • Pilot Projects • Self-Help Groups* • Social Support • methods* • psychology*}, Abstract = {Despite the widespread losses from AIDS, there have been no published evaluations of mental health interventions for people experiencing AIDS-related bereavement. We describe a cognitive behavioural coping model for support group interventions with people who experience an AIDS-related loss. The support group model consists of six primary components to address grief-related responses and the unique features of AIDS bereavement: social support and group cohesion; identification and expression of emotion; identification of AIDS loss specific coping challenges; recognition of current coping; goal setting; and, implementation of adaptive coping to reduce psychological distress. The model integrates theories of cognitive behavioural coping within a social support group context. Results of a pilot study with four men and four women showed that the intervention model cast into eight group sessions significantly reduced depression, intrusive experiences, grief reactions, demoralization, and overall psychological distress immediately following the intervention and at a 3-month follow-up assessment. The intervention appeared to facilitate the adjustment of these bereaved persons and warrants further study.}, Language = {eng}, Doi = {10.1080/09540129550126416}, Key = {fds254089} } @article{fds90817, Author = {RA Roffman and SC Kalichman and JA Kelly and RA Winett and LJ Solomon and KJ Sikkema and AD Norman and LL Desiderato and MJ Perry and AL Lemke}, Title = {HIV antibody testing of gay men in smaller US cities.}, Journal = {AIDS care}, Volume = {7}, Number = {4}, Pages = {405-13}, Year = {1995}, ISSN = {0954-0121}, url = {http://dx.doi.org/10.1080/09540129550126362}, Keywords = {Adult • Decision Making • HIV Infections • Homosexuality, Male* • Humans • Male • Residence Characteristics* • Risk-Taking* • Sexual Behavior • United States • diagnosis • prevention & control*}, Abstract = {The incidence of new AIDS diagnoses among gay males indicates that risk reduction in smaller communities may be lagging behind that reported in larger cities. Contradictory evidence exists, largely from urban areas, concerning the utility of HIV testing as a means of promoting behavioural change. This study examined the relationship between HIV antibody testing and subsequent high-risk sexual behaviours among gay men in cities of 180,000 or fewer inhabitants. In February and March of 1992, male gay bar patrons in sixteen small US cities were administered an anonymous questionnaire concerning recent sexual behaviour and HIV testing history. Of the 1820 respondents, 28.1% had recently engaged in unprotected anal intercourse and 60.7% had been tested for HIV antibodies. Those who had been tested were more sexually active and reported more protected and safer sexual activities. Analyses at the individual and city levels converged to demonstrate that communities as well as individuals evidence increased self-protection in association with HIV antibody testing.}, Language = {eng}, Doi = {10.1080/09540129550126362}, Key = {fds90817} } @article{fds253960, Author = {KELLY, JA and KALICHMAN, SC and SIKKEMA, KJ and MURPHY, DA}, Title = {ON THE NEW CALL FOR HIV PREVENTION RESEARCH - REPLY}, Journal = {American Psychologist}, Volume = {49}, Number = {12}, Pages = {1094-1094}, Publisher = {AMER PSYCHOLOGICAL ASSOC}, Year = {1994}, Month = {December}, ISSN = {0003-066X}, url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:A1994PW53600019&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=47d3190e77e5a3a53558812f597b0b92}, Key = {fds253960} } @article{fds253973, Author = {Perry, MJ and Solomon, LJ and Winett, RA and Kelly, JA and Roffman, RA and Desiderato, LL and Kalichman, SC and Sikkema, KJ and Norman, AD and Short, B}, Title = {High risk sexual behavior and alcohol consumption among bar-going gay men.}, Journal = {Aids}, Volume = {8}, Number = {9}, Pages = {1321-1324}, Year = {1994}, Month = {September}, ISSN = {0269-9370}, url = {http://www.ncbi.nlm.nih.gov/pubmed/7802987}, Keywords = {Adult • Alcohol Drinking* • HIV Infections • Homosexuality, Male* • Humans • Male • Questionnaires • Risk-Taking • Sexual Behavior* • United States • prevention & control • psychology* • transmission}, Abstract = {OBJECTIVES:To determine whether alcohol use prior to sexual behavior influenced the occurrence of unprotected anal intercourse among bar-going gay men. METHODS:Anonymous AIDS behavioral risk surveys were administered to men entering gay bars in 16 cities on three nights in February 1993 in six states in the United States. RESULTS:Of the 1519 men who completed the survey, 85% were current alcohol drinkers. Men who had unprotected anal intercourse after consuming alcohol drank more and reported more incidents of unprotected anal intercourse than men who had unprotected anal intercourse but not after drinking. Overall, unprotected anal intercourse occurred less frequently after alcohol consumption than without prior consumption. CONCLUSIONS:This study found that heavy alcohol use and frequent high-risk sexual behavior occurred among the same individuals. However, we found no evidence for a causal link between alcohol use and unprotected sexual behavior in this sample of bar-going gay men.}, Language = {eng}, Doi = {10.1097/00002030-199409000-00016}, Key = {fds253973} } @article{fds253974, Author = {Kalichman, SC and Sikkema, KJ}, Title = {Psychological sequelae of HIV infection and AIDS: Review of empirical findings}, Journal = {Clinical Psychology Review}, Volume = {14}, Number = {7}, Pages = {611-632}, Publisher = {Elsevier BV}, Year = {1994}, Month = {January}, ISSN = {0272-7358}, url = {http://dx.doi.org/10.1016/0272-7358(94)90001-9}, Abstract = {We review empirical studies that describe and explain the psychological sequelae of HIV infection. Following a brief discussion of methodological issues concerning this literature, studies of the psychological dimensions of HIV and AIDS are reviewed. Research shows that a wide-range of psychological distress reactions are associated with HIV infection. Depression appears to be prevalent in the early phases of HIV disease, subsiding during asymptomatic periods, and recurring with the onset of HIV-related illness symptoms. Depression is also complicated by frequency of bereavement from AIDS-related deaths. Suicide risk is high and follows a pattern similar to depression during the course of the disease. Anxiety and somatization are also prevalent among HIV infected persons. Unfortunately, anger and guilt, two important emotional reactions, have been extremely under-studied. The empirical literature leads to several practical implications for psychological consultation, assessment, and therapy for persons with HIV infection. © 1994.}, Doi = {10.1016/0272-7358(94)90001-9}, Key = {fds253974} } @article{fds253975, Author = {Kelly, JA and Kalichman, SC and Sikkema, KJ and Murphy, DA}, Title = {Kelly et al. Reply}, Journal = {American Psychologist}, Volume = {49}, Number = {12}, Pages = {1094}, Year = {1994}, Month = {January}, ISSN = {0003-066X}, url = {http://dx.doi.org/10.1037/0003-066x.49.12.1094.a}, Doi = {10.1037/0003-066x.49.12.1094.a}, Key = {fds253975} } @article{fds253972, Author = {Kelly, JA and Murphy, DA and Sikkema, KJ and Kalichman, SC}, Title = {Psychological interventions to prevent HIV infection are urgently needed. New priorities for behavioral research in the second decade of AIDS.}, Journal = {American Psychologist}, Volume = {48}, Number = {10}, Pages = {1023-1034}, Year = {1993}, Month = {October}, ISSN = {0003-066X}, url = {http://www.ncbi.nlm.nih.gov/pubmed/8256875}, Keywords = {Acquired Immunodeficiency Syndrome • HIV Infections • Health Behavior* • Health Education* • Health Knowledge, Attitudes, Practice • Humans • Risk Factors • prevention & control* • psychology • transmission}, Abstract = {Behavior change remains the only means for primary prevention of HIV disease. Psychology should take a leading role in efforts to curtail the epidemic, but has not contributed to HIV prevention at a level proportionate to the urgency of the crisis. The authors propose an updated agenda for behavioral research on AIDS-HIV prevention implementing accelerated community trials of promising behavior change models, conducting trials of community-level interventions on a large scale and focused on populations most vulnerable to HIV infections, establishing partnerships between HIV research and community service organizations, integrating efforts from across psychology disciplines to advance and refine HIV prevention interventions, and mobilizing interdisciplinary HIV prevention resources and communication mechanisms to rapidly translate research findings to community and public policy arenas.}, Language = {eng}, Doi = {10.1037//0003-066x.48.10.1023}, Key = {fds253972} } @article{fds253970, Author = {Kelly, JA and Murphy, DA and Roffman, RA and Solomon, LJ and Winett, RA and Stevenson, LY and Koob, JJ and Ayotte, DR and Flynn, BS and Desiderato, LL}, Title = {Acquired immunodeficiency syndrome/human immunodeficiency virus risk behavior among gay men in small cities. Findings of a 16-city national sample.}, Journal = {Archives of Internal Medicine}, Volume = {152}, Number = {11}, Pages = {2293-2297}, Year = {1992}, Month = {November}, ISSN = {0003-9926}, url = {http://dx.doi.org/10.1001/archinte.1992.00400230101017}, Abstract = {BACKGROUND: Most research on acquired immunodeficiency syndrome has been conducted in several of the country's largest cities, and little is known about the current level of human immunodeficiency virus risk taking among gay men in other geographical areas. The purpose of this study was to determine the frequency of risk behavior practices among gay men in smaller communities. METHOD: A large sample of men who patronized gay bars in 16 small and moderate-size cities drawn from six states in four different regions of the country was surveyed to determine the frequency of high-risk behavior and factors influencing risk taking. Eighty-five percent of men in all cities' bars completed all survey measures. The community samples were 1991 men; mean age, 31.3 years; mean education, 10.6 years; 90% were white and 10% were of other ethnicities. All participants provided detailed information on their sexual behavior practices over the preceding 2 months and completed measures assessing their perceived peer norms concerning safer sex practices and risk avoidance, intentions to avoid risk, personal risk estimation, acquired immunodeficiency syndrome risk knowledge, perceived threat of acquired immunodeficiency syndrome/human immunodeficiency virus, and serostatus testing history. RESULTS: High-risk patterns were still common among gay men in these smaller cities; nearly one third of all men had engaged in unprotected anal intercourse an average of eight times in the past 2 months, usually outside monogamous relationships. High-risk behavior was most strongly associated with beliefs that safer sex practices would not be well accepted by peers, weak intentions to use condoms, underestimation of personal vulnerability to the acquired immunodeficiency syndrome, younger age, and higher levels of overall sexual activity. Nine percent of men tested said they were seropositive. CONCLUSIONS: Growing human immunodeficiency virus prevalence and continued high rates of risk behavior indicate that a new "front line" for human immunodeficiency virus prevention among homosexually active men has shifted to the country's smaller cities. Community prevention efforts in these areas are urgently needed to avert sharp increases in future human immunodeficiency virus infections in this population.}, Doi = {10.1001/archinte.1992.00400230101017}, Key = {fds253970} } @article{fds287957, Author = {Winett, RA and Anderson, ES and Moore, JF and Sikkema, KJ and Hook, RJ and Webster, DA and Taylor, CD and Dalton, JE and Ollendick, TH and Eisler, RM}, Title = {Family/media approach to HIV prevention: results with a home-based, parent-teen video program.}, Journal = {Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association}, Volume = {11}, Number = {3}, Pages = {203-206}, Year = {1992}, Month = {January}, ISSN = {0278-6133}, url = {http://www.ncbi.nlm.nih.gov/pubmed/1618175}, Abstract = {We describe the first study with a home-based HIV prevention video program for parents and young teenagers. The objectives of the program are to inform parents and teenagers about the causes and prevention of HIV infection and other sexually transmitted diseases, to increase family problem-solving skills, and to increase teen problem-solving and assertiveness skills. The objectives pertain to the goals of increasing skills needed to help teenagers avoid or manage high-risk behaviors and situations. Forty-five families with at least one 12- to 14-year-old were randomly assigned to either experimental (receive video program) or control (no video) conditions in a pretest-posttest design. After 6 months (Follow-Up 1), the experimental and control families were reassessed. The control families next received the video program, and the control families were assessed again (Follow-Up 2). The results indicate increases in parent and teen knowledge and skills only with video viewing. Approaches to improving the video program, particularly with teenagers, are discussed.}, Doi = {10.1037//0278-6133.11.3.203}, Key = {fds287957} } %% Books @book{fds253892, Author = {Sikkema, KJ and Kochman, A and van den Berg, JJ and Hansen, NB and Watt, MH}, Title = {LIFT: Living in the face of trauma - An intervention for coping with HIV and trauma}, Publisher = {Duke University}, Year = {2009}, Key = {fds253892} } %% Other @misc{fds303807, Author = {Sikkema, KJ}, Title = {Assessment and treatment of depression in HIV disease, Review of HIV and Depression: Context and Care}, Journal = {Contemporary Psychology: a Journal of Reviews}, Volume = {49}, Pages = {58-59}, Year = {2015}, Month = {April}, ISSN = {0010-7549}, Key = {fds303807} } @misc{fds253901, Author = {Sikkema, KJ}, Title = {Review of AIDS: Sexual Behavior and Intravenous Drug Use}, Journal = {Annals of Behavioral Medicine : a Publication of the Society of Behavioral Medicine}, Volume = {12}, Pages = {86-87}, Publisher = {Springer-Verlag}, Year = {1990}, ISSN = {1532-4796}, Key = {fds253901} } | |
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