Stress, coping, and high-risk sexual behavior.

Examined the relation between stress, coping, and a high-risk sexual behavior (unprotected anal intercourse [UAI]) in 398 nonmonogamous gay and bisexual men. UAI during the previous month, the amount of stress experienced during the previous month in each of 10 domains, 6 types of coping, and spiritual beliefs and activities were assessed through self-report. There was no relation between stress and UAI, but there was between coping and UAI. Ss who reported UAI used sex more to help cope with stressful situations. UAI was negatively associated with seeking social support and spiritual activities and positively associated with self-controlling coping, which involves keeping one's feelings to oneself, and positive reappraisal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping disposition, perceived risk, and psychological distress among women at increased risk for ovarian cancer.

The authors examined predictors of psychological distress among women who were at increased risk for ovarian cancer. Participants were 103 women who had at least 1 first degree relative with ovarian cancer. Specifically, the authors tested the relationship between the dispositional attentional style of monitoring (the tendency to scan for threat-relevant information), perceptions of risk for ovarian cancer, intrusive thoughts regarding ovarian cancer, and psychological distress. Overall, this sample exhibited moderately high levels of psychological distress. High scores on monitoring were associated with high perceived risk for ovarian cancer and elevated levels of intrusive thoughts and psychological distress. Finally, the authors proposed and tested a path model describing the interrelationships between these variables. Results of this study are discussed in terms of their implications for treating the psychological distress associated with being at increased risk for ovarian cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Kaposi sarcoma of the lungs in patients with acquired immunodeficiency syndrome (AIDS). Thoracic radiography and scanning

Twenty-four patients with AIDS presenting with Kaposi's sarcoma of the lung were retrospectively studied to assess the merits of thoracic radiographs and of CT for the diagnosis of this disease. Evidence for Kaposi's sarcoma of the lung was given by a characteristic fiberendoscopic appearance in 10 cases and by the histologic diagnosis in 14 cases. All patients had chest radiographs and 14 patients a concomitant thoracic CT study. Chest radiographs showed perihilar opacities in 18 patients, nodules in 8, mediastinal and/or hilar adenopathies in 2 and pleural effusion in 16. Comparison of the patients who had had thoracic radiographs and a CT scan showed better detection of adenopathies, described in 2 cases on chest radiographs and 7 on CT scans, and of nodules, detected in 5 cases on chest radiographs and 6 on CT scans. In 12 patients with perihilar opacities on thoracic radiographs, CT provided a better view of the peribronchovascular distribution of these opaque areas. In 1 patient, CT showed peribronchovascular thickening while radiographs were normal. In 1 patient, both examinations were normal. This study emphasizes the merits of thoracic radiographs and, even more, of CT for the diagnosis of Kaposi's sarcoma of the lung. Peribronchovascular thickening appears to be a characteristic sign that is well analyzed with computed tomography. Since histological evidence of Kaposi's sarcoma is rarely obtained because of the aggressive nature of biopsies in such patients, CT has an important role for the diagnosis of this condition.     

Contraceptive behavior among intravenous drug users at risk for AIDS.

Examined factors associated with practicing contraception among 319 street-recruited iv drug users in New York City. The Ss were administered a structured interview covering AIDS risk behaviors, drug use history, and sexual behavior. Slightly over half of Ss (52%) were practicing contraception, primarily with condoms and birth control pills. Among 220 male Ss, contraception was associated with being non-Hispanic, being unmarried, having a home, and AIDS-related changes in drug injection behavior. Among 99 female Ss, it was associated with having multiple sexual partners. Although concern about AIDS was evident in Ss' behavior, there are multiple determinants (ethnic group membership, situational practicalities, and concern about AIDS) in practicing contraception, and the level of contraception among this group will still result in many unwanted pregnancies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood sexual abuse and sexual risk behavior among men and women attending a sexually transmitted disease clinic.

Childhood sexual abuse (CSA) is associated with a wide range of negative outcomes. The authors investigated the relation between CSA and sexual risk behavior in 827 patients recruited from a sexually transmitted disease (STD) clinic. Overall, CSA was reported by 53% of women and 49% of men and was associated with greater sexual risk behavior, including more sexual partners, unprotected sex, and sex trading. Alcohol use for men and drug use for women mediated the relation between CSA and the number of sexual partners in the past 3 months; intimate partner violence mediated the relation between CSA and the number of episodes of unprotected sex in the past 3 months for women. These results document the prevalence of CSA among patients seeking care for an STD and can be used to tailor sexual risk reduction programs for individuals who were sexually abused. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol-involved sexual risk behavior among heavy drinkers living with HIV/AIDS: Negative affect, self-efficacy, and sexual craving.

Evidence of the effects of negative affect (NA) and sexual craving on unprotected sexual activity remains scant. We hypothesized that NA and sexual craving modify the same day association between low self-efficacy to use condoms and unprotected anal or vaginal sex, and the same-day association between alcohol use during the 3 hours prior to sexual activity and unprotected sex. We used an electronic daily diary, drawing on a sample of 125 men and women recruited from an agency serving economically disadvantaged persons living with HIV/AIDS. Casual or steady partner type designation and perceived partner HIV serostatus were also examined. Findings support the hypothesized moderating effects of high NA and sexual craving on the association between low self-efficacy and unprotected sex, and the association between alcohol use and unprotected sex. Implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social control, health risk taking, and psychological distress among the elderly.

Most research on older adults' social networks has focused on the support-providing function of social relationships. Little gerontological research has addressed social control, or the role of social bonds in regulating deviant or risky behavior. Drawing on sociological theory, this study examined the hypothesis that social control discourages risky health practices while provoking psychological distress. Structured interviews conducted with 162 community-residing older adults assessed social control (direct attempts by others to influence participants' health practices and the existence of significant role obligations to others), health risk taking (medication misuse, alcohol consumption, cigarette smoking, and the overall level of unsound health practices), psychological functioning (depression, loneliness, and self-esteem), and interpersonal satisfaction (satisfaction with friends and family members). Analyses revealed little support for the hypothesis. Social control was only weakly related to participants' health practices and, contrary to expectation, was generally related to less psychological distress and to greater interpersonal satisfaction. Implications for social control theory and for further research are addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors associated with severity of depression and high-risk sexual behavior among persons diagnosed with human immunodeficiency virus (HIV) infection.

Whereas some people appear to cope after learning that they have HIV infection, others experience depression and suicidal ideation. In this study, 142 persons with HIV infection were administered the Center for Epidemiological Studies Depression Scale. High levels of depression were predicted by lower perceived social support, attributions that health was influenced more by chance, high-risk sexual behavior practices, and greater number of HIV illness symptoms and greater duration of time knowing of one's own positive serostatus. Ongoing high-risk sexual behavior practices were predicted by higher levels of recreational drug use and of depression. These findings highlight the need for improved mental health services for persons with HIV conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Negative affect and sexual risk behavior: Comment on Crepaz and Marks (2001).

In this commentary, the authors highlight the findings of the meta-analysis by N. Crepaz and G. Marks (see record 2001-11106-006). The role of affect in sexual risk behavior, although intuitively obvious, is not well understood and has been largely ignored by HIV prevention researchers in favor of social-cognitive models of behavior. Crepaz and Marks synthesized the results from studies that have examined the relation of negative affect (e.g., depression, anxiety, anger) to sexual risk behavior and concluded that in the literature to date, these variables appear unrelated. The authors suggest that the Crepaz and Marks findings are not surprising given the methods used in the reviewed studies and suggest methodological approaches that will allow more sensitive analyses of the association between affect and sexual risk behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence of IgG and IgM anti-Toxoplasma antibodies in patients with HIV and acquired immunodeficiency syndrome (AIDS)

OBJECTIVE/STUDY DESIGN: After blood loss, production of erythropoietin in adults increases, which accelerates erythropoiesis and restores the erythroid mass. It is unclear whether preterm infants with large phlebotomy losses have a similar response. We therefore measured serum erythropoietin concentrations in 11 ill preterm infants (1057 +/- 167 gm) as their phlebotomy losses accumulated. RESULTS: Before the first transfusion, erythropoietin concentrations were 68.9 +/- 36.2 mU/ml (range 0 to 205 mU/ml) at 5 ml/kg blood out, 17.4 +/- 8.9 mU/ml at 10 ml/kg, and 4.8 +/- 2.6 mU/ml at 15 ml/kg. Erythropoietin concentrations did not increase in any patients despite increasing phlebotomy losses. CONCLUSION: Serum erythropoietin concentrations in ill preterm infants do not increase in the face of significant blood loss. Although the mechanistic explanation for this failure is unclear, it likely contributes to the transfusion requirements of this population.     

Quantitative assessment of cross-sectional muscle area, functional status, and muscle strength in men with the acquired immunodeficiency syndrome wasting syndrome

The acquired immunodeficiency syndrome wasting syndrome (AWS) in men is characterized by the loss of lean body mass out of proportion to weight. Although the wasting syndrome has been thought to contribute to reduced functional capacity, the relationships among lean body mass, muscle size, functional status, and regional muscle strength have not previously been investigated in this population. In this study, 24 eugonadal men with the AWS (weight <90% of the ideal body weight or weight loss >10% from preillness maximum) underwent determination of body composition by dual energy x-ray absorptiometry (DXA), 40K isotope analysis, urinary creatinine excretion, and quantitative computed tomographic analysis of cross-sectional muscle areas of the midarm and thigh. Overall exercise functional capacity was evaluated using the 6-min walk test, and performance of upper and lower extremities was determined with the quantitative muscle function test. Subjects were 37 +/- 1 yr of age and weighed 95.5 +/- 3.0% of ideal body weight, with a body mass index of 21.9 +/- 0.7 kg/m2 and an average weight loss of 15 +/- 1%. The mean CD4 count among the subjects was 354 +/- 70 cells/mm3, and viral load was 58,561 +/- 32,205 copies. Sixty-two percent of subjects were receiving protease inhibitor therapy. The subjects demonstrated 90% of the expected muscle mass by the creatinine height index method. Overall performance status on the Karnofsky scale was highly correlated to weight (r = 0.51; P = 0.018; by body mass index), lean body mass (r = 0.46; P = 0.036; by DXA), and body cell mass (r = 0.47; P = 0.037; by 40K isotope analysis). Cross-sectional muscle area of the upper extremity was the best predictor (P < 0.001) of Karnofsky score, accounting for 52% of the variability in a stepwise regression analysis. Upper body muscle strength was most significantly predicted by lean body mass (by DXA; r2 = 0.78; P < 0.0001), whereas lower body strength and performance on the 6-min walk test were best predicted by lower extremity cross-sectional muscle area (r2 = 0.70; P < 0.0001 and r2 = 0.26; P = 0.030, respectively). These data demonstrate that cross-sectional muscle area is highly predictive of functional status and muscle strength in men with the AWS.     

高危性行为与性病艾滋病知识及感染状况调查

目的 了解宜昌市嫖客人群艾滋病相关知识、高危行为方式、艾滋病(AIDS)及性病(STD)感染状况.方法 采用个人访谈的形式对450名嫖客人群进行了相关调查与HIV/STD感染状况检测.结果 450名嫖客中有关艾滋病传播等知识单题知晓率在40.56%～90.37%之间;嫖客中阴道交、口交和二者并存分别占81.11%、5.11%和13.78%,其安全套使用率分别为46.03%、4.35%和33.87%,差异具有显著性意义(x2=17.20,P＜0.01);嫖客中HIV抗体、梅毒和生殖道沙眼衣原体检出阳性率分别为0.44%、4.65%和6.13%,生殖器疱疹和尖锐湿疣现患率分别为5.66%和9.43%,4种性病的未使用安全套暴露组与全程使用安全套对照组的相对危险度RR值在7.46～13.91之间,差异具有极显著性意义(x2值在7.01～11.09之间,P＜0.01).结论 宜昌市嫖客人群中的性传播疾病知识知晓率与安全套使用率相对较低,HIV/STD感染率较高,应加强嫖客与暗娼人群的行为干预.     

Social, emotional, and intellectual behavior at school among children at high risk for schizophrenia.

Four classroom teachers rated the school behavior of 44 12–17 yr olds of schizophrenic parents and 70 Ss of normal parents as part of an ongoing high-risk study. The ratings were made by teachers using the Pupil Rating Form and the Hahnemann High School Behavior Rating Scale. Ss of schizophrenic parents showed greater interpersonal disharmony, less scholastic motivation, more emotional instability, and lower intelligence than the control Ss, but the difference in introversion was not significant. Two of the 4 Ss with 2 schizophrenic parents had extremely low ratings for scholastic motivation, harmony, emotional stability, and intelligence and a 3rd was rated extremely low on emotional stability, but none of them was extremely introverted. On the basis of the results and a preliminary examination of intermediate outcomes (early hospitalization or psychological treatment after the initial school assessments), it is concluded that disharmony, emotional instability, and low intelligence are the early markers for vulnerability to schizophrenia worthy of most attention. The surprising absence of introverted behavior among Ss of schizophrenic parents indicates that introversion—when it is observed—may best be construed not as a static typology of preschizophrenic character but as a dynamic phase in a process of coping and retreat that precedes schizophrenic breakdown, sometimes by many years. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Perceived group devaluation, depression, and HIV-risk behavior among Asian gay men": Correction to Chae and Yoshikawa (2008).

Reports an error in "Perceived group devaluation, depression, and HIV-risk behavior among Asian gay men" by David H. Chae and Hirokazu Yoshikawa (Health Psychology, 2008[Mar], Vol 27[2], 140-148). In the aforementioned article, the second sentence of the Results portion of the abstract should read: Among participants most attracted to Whites, group devaluation was associated with higher levels of nonprimary partner UAI; but was associated with lower levels of nonprimary partner UAI among those most attracted to non-Whites. (The following abstract of the original article appeared in record 2008-03424-002.) Objective: This study examined depressive mood and HIV-risk behavior in relation to perceived group devaluation and group identity. Design: Cross-sectional survey of 192 Asian gay men. Main Outcome Measures: Depressive mood assessed using the Centers for Epidemiological Studies Depression Scale (CES-D) and self-reported receptive or insertive unprotected anal intercourse (UAI) in the past 3 months. Results: Group devaluation was positively associated with depressive mood. Among participants most attracted to Whites, group devaluation was associated with higher levels of nonprimary partner UAI, among those most attracted to non-Whites. Among participants reporting higher levels of group devaluation, those with more positive personal evaluations of the Asian gay community had lower levels of total UAI compared to those with more negative personal evaluations of the Asian gay community. Conclusions: Results suggest that group devaluation is associated with higher levels of depressive mood among Asian gay men. Asian gay men most attracted to non-Whites or hold more positive evaluations of their group may be buffered from the influence of high perceived group devaluation on UAI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual compulsivity, state affect, and sexual risk behavior in a daily diary study of gay and bisexual men.

Researchers have identified a strong link between sexual compulsivity (SC) and risky sexual behavior among men who have sex with men (MSM). Meanwhile, affect/mood has also been connected with negative sexual health outcomes (sexually transmitted infection/human immunodeficiency virus [HIV] transmission, sexual risk, sex under the influence of drugs/alcohol). Given that SC is characterized by marked distress around one's own sexual behavior, affect may play a central role in SC and HIV risk behavior. Data were taken from the Pillow Talk Project, a pilot study conducted in 2008–2009 with 50 highly sexually active MSM (9 or more male sex partners, ≤ 90 days), of which half displayed SC symptoms and half did not. Forty-seven men completed a daily diary online for 30 days (n = 1,060 diary days), reporting on their sexual behavior and concurrent affect: positive activation, negative activation, anxious arousal, and sexual activation. We conducted HLM analyses using daily affect (Level 1, within subjects) and SC and HIV status (Level 2, between subjects) to predict sexual behavior outcomes. Increased negative activation (characterized by fear, sadness, anger, and disgust) was associated with reduced sexual risk behavior, but less so among sexually compulsive MSM. Sexual activation was associated with increased sexual risk taking, but less so among sexually compulsive MSM. Anxious arousal was associated with increased sexual behavior, but not necessarily sexual risk taking. Findings indicate that affect plays key roles in sexual behavior and sexual risk taking; however, the association between affect and behavior may be different for sexually compulsive and non-sexually compulsive MSM. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in HIV treatment beliefs and sexual risk behaviors among gay and bisexual men, 1997-2005.

Objective: Beliefs about HIV treatment effectiveness and the impact of HIV treatments on HIV transmission risks were initially related to sexual risk-taking in the late 1990s when multidrug HIV treatments first became available. This study examined changes in beliefs about the effects of HIV treatment for preventing HIV transmission and their association to sexual risk behaviors between the years 1997 and 2005. Design: Anonymous surveys were administered to a convenience sample of gay and bisexual men attending a large community event in Atlanta, Georgia in 1997 (N = 498) and again at the same community event in 2005 (N = 448). Analyses were performed for men living with HIV/AIDS and for men who have not been diagnosed with HIV/AIDS. Main Outcome Measures: Rates of unprotected anal intercourse in the previous 3 months. Results: There were significant increases in high-risk sexual practices that coincided with increased beliefs that HIV treatments can reduce the chance of transmitting HIV. However, optimistic beliefs about the health benefits of HIV treatments decreased over the 8 years and were not related to risk behaviors. Conclusions: Beliefs about how HIV treatments impact HIV infectiousness remain associated with HIV transmission risk behavior and interventions targeting at-risk as well as HIV-positive men who have sex with men must directly address these beliefs and perceptions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality and cognitive factors influencing substance use and sexual risk for HIV infection among gay and bisexual men.

Substance use reliably predicts sexual risk behavior, and sensation-seeking personality characteristics have been found to covary with these associations. In a study of 289 gay and bisexual men attending a large gay pride event, the authors examined the role of substance use sexual outcome expectancies in explaining associations between sensation seeking, substance use, and risky sex. Consistent with previous research, alcohol and other drugs were associated with sexual behavior. However, path analyses showed that sensation seeking accounted for variance in sexual behavior over and above substance use before sex and that sensation seeking predicted substance use expectancies that in turn predicted substance use before sex. It was concluded that altering substance use outcome expectancies may be an important strategy for HIV risk reduction for individuals high in sensation seeking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Infants at social risk: Relations among infant maltreatment, maternal behavior, and infant attachment behavior.

Fifty-six 12-mo-old infants, including 10 maltreated infants, 18 nonmaltreated high-risk infants, and 28 matched low-income controls, were videotaped in naturalistic settings at home with their mothers for 40 min and were observed 2 weeks later in the Ainsworth Strange Situation. Maltreating mothers were rated higher than nonmaltreating mothers on covertly hostile and interfering behaviors toward their infants at home. Maltreated infants were more avoidant of their mothers in the Strange Situation than nonmaltreated infants. Correlations between maternal behaviors at home and infant behaviors in the Strange Situation revealed that mothers whose infants displayed resistant behavior on reunion were rated at home as less verbally communicative and mothers whose infants displayed avoidant behavior on reunion were rated at home as more covertly hostile. Infants showing mixed avoidance and resistance were more likely to have extremely uncommunicative mothers than were infants who showed avoidance alone. Use of the behavioral rating scales for avoidance and resistance produced clearer findings than use of the final attachment classifications. Reasons for the discrepancies between analyses of classifications and analyses of behavior ratings were identified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)