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Descriptors:
Acquired Immunodeficiency Syndrome (AIDS); Student Reaction; Incidence; Sexually Transmitted Diseases; At Risk Persons; Health Behavior; High School Students; Student Behavior; United States History; Drug Abuse; Gender Differences; Racial Differences; Sexuality

Abstract:
One of the three primary goals of the "National HIV/AIDS Strategy for the United States" is to reduce the number of persons who become infected with human immunodeficiency virus (HIV). In 2009, persons aged 15-29 years comprised 21% of the U.S. population but accounted for 39% of all new HIV infections. To describe trends in the prevalence of HIV-related risk behaviors among high school students, CDC (Centers for Disease Control and Prevention) analyzed data from the biennial national Youth Risk Behavior Survey (YRBS) for the period 1991-2011. The national YRBS, a component of CDC's Youth Risk Behavior Surveillance System, used independent, three-stage cluster samples for the 1991-2011 biennial surveys to obtain cross-sectional data representative of public and private school students in grades 9-12 in all 50 states and the District of Columbia. Sample sizes in the surveys ranged from 10,904 to 16,410. School response rates ranged from 70% to 81%, student response rates ranged from 83% to 90%, and overall response rates ranged from 60% to 71%. The findings in this report suggest that previously reported progress in reducing some HIV-related risk behaviors among students stalled overall and among certain populations of students. Most concerning are the decrease in condom use among black students since 1999 and the lack of any significant decrease since 1991 in the percentage of Hispanic students who have had sexual intercourse, four or more sex partners, and current sexual activity. The findings in this report are subject to at least two limitations. First, these data apply only to youths who attend school and therefore are not representative of all persons in this age group. Nationwide, in 2009, of persons aged 16-17 years, approximately 4% were not enrolled in a high school program and had not completed high school. Second, the extent of underreporting or overreporting of self-reported behaviors cannot be determined, although the survey questions demonstrate good test-retest reliability. To achieve the "National HIV/AIDS Strategy for the United States" goal of reducing the number of persons who become infected with HIV, further improvements in the prevalence of behaviors that contribute to HIV infection among young persons are needed. Renewed educational efforts that reach all students before risk behaviors are initiated and that seek to delay the onset of sexual activity, increase condom use among students who are sexually active, and decrease injection drug use are warranted. (Contains 1 table and 2 figures.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Acquired Immunodeficiency Syndrome (AIDS); Prevention; African Americans; Males; Sexual Orientation; Sexually Transmitted Diseases; Intervention; Urban Areas; Empowerment; Masculinity; Fathers; Health Education; Health Behavior

Abstract:
In the United States, racial disparities in HIV/AIDS are stark. Although African Americans comprise an estimated 14% of the U.S. population, they made up 52% of new HIV cases among adults and adolescents diagnosed in 2009. Heterosexual transmission is now the second leading cause of HIV in the United States. African Americans made up a full two-thirds of all heterosexually acquired HIV/AIDS cases between 2005 and 2008. Few demonstrated efficacious HIV prevention interventions designed specifically for adult, African-American heterosexual men exist. Here, we describe the process used to design a theory-based HIV prevention intervention to increase condom use, reduce concurrent partnering, and increase HIV testing among heterosexually active African-American men living in high HIV prevalence areas of New York City. The intervention integrated empowerment, social identity, and rational choices theories and focused on four major content areas: HIV/AIDS testing and education; condom skills training; key relational and behavioral turning points; and masculinity and fatherhood. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Acquired Immunodeficiency Syndrome (AIDS); Prevention; Sexually Transmitted Diseases; African Americans; Young Adults; Males; Sexual Identity; Homosexuality; Sexual Orientation; Subcultures; Mixed Methods Research; Holistic Approach; Urban Areas; Health Programs; Program Effectiveness; Poverty; Housing; Job Training

Abstract:
African-American young men who have sex with men and transgender persons are at elevated risk for HIV infection. House and Ball communities, networks of mostly African-American gay, bisexual, and transgender individuals who compete in modeling and dance, represent a prime venue for HIV prevention with these difficult-to-reach populations; however, little research exists on effective approaches to HIV prevention within these communities. Using a mixed-methods approach, the present study sought to document participation in HIV prevention activities of a sample from the Los Angeles House and Ball communities (n = 263) in order to inform future service development. While 80% of participants were tested for HIV within the past 6 months, only 26% report HIV prevention program attendance. House leaders recommend a holistic approach to HIV prevention, one that incorporates attention to social problems beyond HIV, including poverty, housing difficulties, and lack of job training. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Acquired Immunodeficiency Syndrome (AIDS); Adolescent Development; Mothers; Daughters; Focus Groups; Sexually Transmitted Diseases; Family Relationship; Risk; Sexuality; Parent Child Relationship; African Americans; Adolescents; Behavior Change; Expectation; Values

Abstract:
Mother-daughter communication plays an influential role in adolescent development. The impact of maternal HIV infection on family communication is not clear. This study explores how living with HIV impacts sexual risk communication between mothers and daughters and whether maternal HIV status influences adolescent choices about engagement in HIV risk behaviors. Data were collected from 12 African American women and 10 of their adolescent daughters through focus groups. Both mothers and daughters shared information about issues that promoted and inhibited communication and engagement in risk behaviors. Findings show that HIV status served as a mechanism for behavioral change related to communication and risk engagement behaviors. Therefore, HIV-infected mothers should be supported in communicating values and expectations to their daughters. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Sexuality; Acquired Immunodeficiency Syndrome (AIDS); Prevention; Sexually Transmitted Diseases; Intervention; Semi Structured Interviews; African Americans; Contraception; Females; Risk; Health Behavior; Barriers; Coding; Behavior Change; Qualitative Research; Decision Making

Abstract:
Human immunodeficiency virus (HIV) interventions can significantly reduce risky sexual behaviors among vulnerable populations. However, not everyone exposed to an intervention will reduce their sexual risk behavior. This qualitative study sought to identify factors associated with young African American females' lack of increase in condom use post-participation in an HIV prevention intervention. Semi-structured interviews were conducted with 50 young African American women (18-23 years; approximately half were mothers) after participating in a demonstrated effective HIV prevention intervention; 24 did not increase condom use post-intervention. Interviews were thematically coded for barriers to condom-use post-intervention. Although nearly all young women reported partner-associated challenges to using condoms, there were relational differences observed among those who changed their condom use versus those who did not. Many "non-changers" were engaged in non-stable "on and off" relationships, with high rates of infidelity, often with the father of their child, in which they were fearful of requesting condom use. "Non-changers" also reported more substance use, feeling incapable of change and not thinking about condom use. Thus, future HIV prevention efforts may benefit from incorporating strategies on how young mothers can maintain a non-sexual relationship with their child's father, as well as elaborating on the intersection of substance use and risky sexual decision-making. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Acquired Immunodeficiency Syndrome (AIDS); Sexually Transmitted Diseases; Epidemiology; Etiology; African American Community; Career Development; Research and Development; Medical Research; Interviews; Researchers

Abstract:
Nearly 30 years ago, renowned immunologist James E.K. Hildreth, M.D., Ph.D., was compelled to start researching the virus that causes AIDS. He marveled at its enigma and was pressed into action by its ability to cut lives short and devastate communities. The disease set him on a course of medical inquiry that has included biomedical breakthroughs in understanding its transmission. In this conversation, Dr. Hildreth discusses his latest move to UC Davis, his tenure at Meharry Medical College, why he's frightened for Black women and what makes him hopeful about HIV/AIDS 30 years after the first AIDS cases were reported in the United States. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Intervention; Institutionalized Persons; African Americans; Females; Adolescents; Juvenile Justice; Employment; Sexually Transmitted Diseases; Drug Use; Acquired Immunodeficiency Syndrome (AIDS); Decision Making; Correlation; At Risk Persons

Abstract:
This manuscript assesses priorities and challenges of adolescent females by conducting a meeting with teen advisory board (TAB) members to collect information regarding their lives and experiences pre-, during and post-incarceration in a juvenile detention facility. Multiple themes emerged regarding the impact of incarceration on young African-American females, including experiencing a loss of personal liberties, the importance of making money upon release, unfaithfulness by partners on the "outside", substance use and lack of control over their environment upon release, including parents, peers and male sexual partners. Based on feedback from TAB members, unique barriers and challenges were identified that suggested areas where adaptations to an evidenced-based HIV/sexually transmitted disease (STD) intervention would be justified to more adequately meet the needs of this particular subgroup of young African-American women. Adaptations to the evidence-based interventions included enhancing activities related to goal setting, emotion regulation skills, decision-making, recognizing and utilizing support networks and addressing the relationship between substance use and risky sexual behavior. Future health education efforts focusing on either the creation of new HIV/STD interventions or adaptations to existing interventions should consider utilizing advisory boards with members of the priority population at the earliest stages of intervention planning. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Acquired Immunodeficiency Syndrome (AIDS); Testing; Sexually Transmitted Diseases; Intention; Marketing; African Americans; Correlation; Knowledge Level; Beliefs; Diagnostic Tests; Females; Regression (Statistics); Behavior Change

Abstract:
Objective: To examine whether there is an association between knowledge, attitudes and beliefs, reported intentions to get an HIV test, and reported HIV testing behaviour at a later date among a sample of African American women. Design: Secondary analysis of data collected from October 2007 through March 2008 for a randomized controlled experiment that was one part of a comprehensive evaluation of the "Take Charge. Take the Test" HIV social marketing campaign. Method: A series of logistic regression models were estimated to assess the effects of baseline knowledge and attitudes and beliefs on intention at two and six weeks post-baseline. Logistic regression models were also estimated to assess the effects of intention on HIV testing at both follow-ups. Results: A statistically-significant association between baseline attitudes and beliefs and subsequent HIV testing intentions was found. Knowing where to get a free HIV test at baseline was also significantly associated with reported intentions at follow-up. Reported intentions were significantly associated with reported HIV testing at follow-up. Conclusion: The study's findings reiterate the importance of applying behaviour change theories and measuring behavioural precursors in the design and evaluation of HIV testing campaigns. (Contains 1 figure and 4 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Acquired Immunodeficiency Syndrome (AIDS); Popular Culture; Low Income; Focus Groups; Diagnostic Tests; Sexually Transmitted Diseases; Young Adults; Data Analysis; Sexuality; African Americans; Computer Software; Clinical Diagnosis; Social Bias; Mass Media

Abstract:
A qualitative study examined perceptions of HIV testing and strategies to enhance HIV testing among HIV-negative African American heterosexual young adults (ages 18-25 years). Twenty-six focus groups (13 male groups, 13 female groups) were conducted in two low-income communities (urban and rural). All sessions were audio-recorded and transcribed. Data analysis was completed using AnSWR software. Many participants expressed that learning one's HIV status, regardless of the result, was a benefit of taking an HIV test because this was perceived to produce emotional relief. Additional benefits included the avoidance of unknowingly spreading the virus, being offered treatment access if HIV-positive, and taking time to assess and modify risky sexual behaviors if HIV-negative. If diagnosed HIV-positive, HIV testing concerns included the recognition of one's mortality, the experience of social stigma, and concerns about accessing affordable treatment. Recommended promotion strategies included the use of HIV-positive individuals, pop culture icons, and the media to promote HIV testing messages. (Contains 2 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Acquired Immunodeficiency Syndrome (AIDS); Health Promotion; Multiple Regression Analysis; Predictor Variables; Interpersonal Communication; Communication Problems; African Americans; Knowledge Level; Social Bias; Trust (Psychology); Parents; Age Differences; Gender Differences; Educational Attainment; Family Structure; Prevention; Empowerment

Abstract:
The study examined the relational-behavior survey (RBS) as a predictor of HIV-related parental miscommunication (HPM) among a voluntary sample 75 African American parents at a private healthcare facility located in the southwest region of the United States. A multiple regression analysis indicated that there was significant marginal prediction of the RBS factors (subjective knowledge, knowledge deficiency, relational skills, HIV/STD stigmatization, community empowerment, health distrust) with HPM (R = 0.38, p = 0.09); R squared = 0.14. In an exploratory MRA backward elimination procedure of the RBS factors and contextual variables (parental age, gender, educational level, and the number of children in the household,) there was a significant prediction of HPM (R = 0.51, p less than 0.01); R squared = 0.26. The backward elimination procedure further indicated that parental educational level and relational skills were the strongest predictors of HPM (R = 0.44, p less than 0.01); R squared = 0.19. Based on the findings, the RBS may be useful in the development of family-life skills programs at primary healthcare facilities. (Contains 1 table, 1 figure, and 2 charts.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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