"Psychological interventions are urgently needed to prevent HIV infection: New priorities for behavioral research in the second decade of AIDS": Reply.

Replies to comments by D. R. Holtgrave, R. H. Needle et al, D. Cotton et al, and S. R. Truax (see PA, Vol 82:14725, 14740, 14719, and 14749, respectively) regarding the review by J. A. Kelly et al (see record 1994-10963-001) on interventions designed to prevent HIV transmission. Specific issues raised by the commentators are addressed, and the need is expressed for more behavioral science-based controlled intervention trials. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological interventions with AIDS and HIV: Prevention and treatment.

In the decade since AIDS was first diagnosed, behavioral research has focused intensively on risk reduction change processes and, to a lesser extent, on mental health needs of persons with HIV conditions. Although research to date has yielded important findings for primary prevention efforts and has identified some psychological dimensions relevant to mental health interventions, there is a pressing need for much more systematic intervention outcome research in both the prevention/behavior change and emotional coping areas. Progress in these areas will be facilitated by better linkage of intervention approaches to behavioral theory; identification of intervention elements that produce HIV risk behavior change; evaluated field-testing of promising intervention models; continued focus on populations that remain at risk (such as gay men and iv drug users); and expansion of prevention efforts to urban, poor, and minority populations increasingly threatened as AIDS/HIV enters a "2nd wave." Although AIDS is still a relatively new problem, existing behavioral medicine conceptual models and intervention strategies can be adapted to meet the enormous challenges created by AIDS and HIV infection. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychological distress and neuropsychological complications of HIV infection and AIDS.

AIDS, whether real or threatened, poses a radical challenge to the psychological, social, and practical adaptation of individuals at various stages of human immunodeficiency virus (HIV) disease. The challenge arises from multiple sources, including disease progression, social discrimination, bereavement, pressure for life-style change, and neurological impairment associated with HIV brain infection. The consequences of this challenge to people with HIV infection, AIDS-related complex, AIDS, and AIDS dementia complex are reviewed. The potential for both personal crisis and personal growth in response to this challenge is highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implications of HIV treatment advances for behavioral research on AIDS: Protease inhibitors and new challenges in HIV secondary prevention.

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preventing HIV infection and AIDS in children and adolescents: Behavioral research and intervention strategies.

This article focuses on pediatric and adolescent AIDS. Literature is reviewed on the incidence of AIDS in various age groups, highlighting differences in demographic patterns among pediatric, adolescent, and adult AIDS cases. Behaviors that increase the likelihood that a child or adolescent will contract AIDS, as well as prevention strategies that target the prevention of human immunodeficiency virus (HIV) infection, are discussed. Finally, recommendations are made for social science research directed toward altering behavior associated with HIV. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological interventions and research in the oncology setting: An integrative framework.

Within the context of treatment outcome research in the oncology setting, the authors propose a model that integrates the models of responsibility developed by P. Brickman et al (see record 1982-30315-001), W. T. Powers's (1973) control theory, and E. T. Higgins's (1989) self-discrepancy theory. This integrative approach is patient-centered in its attempt to base an assessment of the psychotherapy or other interventions on an understanding of the patients' self-reference states as they interact with the treatment being assessed and the disorder for which interventions were attempted. The authors highlight some of the ways in which a purely medical treatment, such as chemotherapy, can evoke the type of patient distress whose treatment falls within the domain of psychologists. Cancer patients' internal reference states need to be considered in the respective outcome research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological factors in end-stage renal disease: An emerging context for behavioral medicine research.

End-stage renal disease (ESRD) is a chronic, life-threatening condition afflicting over 300,000 Americans. Patient nonadherence and psychological distress are highly prevalent among ESRD patients, and both have been found to contribute to greater morbidity and earlier mortality in this population. A range of factors have been examined as potential determinants of adherence and adjustment. Evidence suggests that adherence and adjustment are maximized when a patient's preferred style of coping is consistent with the contextual features or demands of the renal intervention the patient is undergoing. Challenges for future clinical research include refining methodologies for the assessment of depression and adherence, more clearly evaluating the efficacy of psychological interventions, and clarifying the role that depression and social support play in influencing patient mortality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Community-based participatory research: Partnering with communities for effective and sustainable behavioral health interventions.

The present issue contains one of the first studies published in Health Psychology—by Resnicow and colleagues—that uses elements of community-based participatory research (CBPR) (Resnicow et al., 2009). The authors engaged community partners (three health maintenance organizations or HMOs) to develop and implement a fruit and vegetable promotion intervention (Tolsma et al., 2009). African American HMO patients (the intervention targets) participated in formative work (i.e., focus groups) on survey items and intervention content and in survey pilot testing. A diverse group of researcher and nonresearcher expert stakeholders (e.g., African American health plan staff; consultants with expertise in Black identity theory, on which the intervention was based) was engaged in major project decisions regarding the measures and intervention design. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

AIDS treatment advances and behavioral prevention setbacks: Preliminary assessment of reduced perceived threat of HIV–AIDS.

Recent advances in AIDS treatment have brought renewed optimism for prolonging the lives of those infected with HIV. This article examined beliefs about how new treatments may reduce HIV transmission risk among 298 HIV-negative gay and bisexual men attending a gay pride festival. Results from an anonymous survey showed that men who practiced unprotected anal intercourse as the receptive partner (UAR intercourse) were younger, less well educated, and more likely to believe that it is safe to have UAR intercourse with an HIV-positive man who has an undetectable viral load and that new treatments for HIV relieve their worries about unsafe sex. As HIV treatments continue to advance, new challenges for HIV prevention will likely emerge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experimental component analysis of a behavioral HIV–AIDS prevention intervention for inner-city women.

A component analysis of a behavioral HIV risk reduction intervention was conducted among 87 women recruited from an inner-city community. Women were randomly assigned to an intervention consisting of (a) sexual communication skills training, (b) self-management skills training, (c) a combination of sexual communication and self-management skills, or (d) HIV education and risk sensitization. Results showed that all 4 intervention conditions increased AIDS knowledge and intentions to reduce risk behaviors. Communication skills training resulted in higher rates of risk reduction conversations and risk refusals. However, the combined skills training condition showed the lowest rates of unprotected sexual intercourse at the 3-month follow-up. This study is the first to experimentally control HIV risk reduction elements in an analysis of a skills-based HIV prevention intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

HIV/AIDS risk in heterosexual college students. A review of a decade of literature

Empirical studies dealing with the psychosocial correlates of HIV risk among heterosexual college students are reviewed, including findings related to such theoretical variables as HIV/AIDS-related knowledge, personal and partner's attitudes toward condom use, perceived susceptibility, communication with sex partners, and sexual self-efficacy. Although college students are highly knowledgeable about basic HIV/AIDS facts, they retain some misperceptions about disease transmission. They hold neutral-to-negative hedonistic and practical attitudes about using condoms: those who have engaged in risky behavior accurately perceive their greater susceptibility to infection and experience anxiety regarding transmission of HIV infection. Heterosexual college students communicate infrequently with their partners about safer sex, but they often agree to a partner's suggestion that they use condoms. Higher levels of sexual self-efficacy among college students have been associated with a lower risk for HIV transmission. Limitations and clinical implications of the findings and recommendations for future interventions are discussed.     

Psychological interventions for cancer patients to enhance the quality of life.

Although the thrust of the nation's cancer objectives for the year 2000 is prevention and screening, each year approximately 1 million Americans are diagnosed and must cope with the disease and treatments. They do so with the aid of family, friends, and the health care system, but accumulating data suggest that psychological interventions may be important for reducing emotional distress, enhancing coping, and improving "adjustment." Experimental and quasi-experimental studies of psychological interventions are reviewed, and a discussion of treatment components and mechanism is offered. A final section discusses future research directions and challenges to scientific advance. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Investigating the acceptability of behavioral interventions in applied conjoint behavioral consultation: Moving from analog conditions to naturalistic settings.

Whereas there exists a vast literature investigating consumer satisfaction ratings of various behavioral interventions, the majority of these studies have been limited to analogue conditions, which may compromise utility and generalization. Additionally, most research has failed to explore multiple-source, multiple-setting data in the investigation of treatment acceptability. This study investigated parent, teacher, and child treatment acceptability ratings derived from field-based conjoint behavioral consultation cases. Data indicate that overall, 67 parents (aged 23-54 yrs), 67 teachers (aged 22-57 yrs), and 67 children (aged 5-15 yrs) rated conjoint behavioral consultation-based behavioral interventions as very to highly acceptable. For parents, interventions with a reductive component were rated as more acceptable than interventions using both positive and negative components; no significant differences were found among teacher and child group ratings. For teachers, there was a positive relationship between (a) intervention complexity and treatment acceptability ratings and (b) problem severity ratings and treatment acceptability ratings... (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Proceedings of the second Annual Meeting of the New England Psychological Association.

The meeting was held November 9-10, 1962, in Boston, Massachusetts. "There were 360 convention registrations. The program consisted of 11 symposia whose participants were invited." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological research and the prevention, etiology, and treatment of AIDS.

An overview of some of the issues and problems related to psychological research on AIDS and human immunodeficiency virus (HIV) infection is presented. Behavioral, cognitive, psychobiological, and neuropsychological issues are examined in relation to the development of a scientific research agenda on AIDS. The role of psychobiological variables in the etiology, treatment, and prevention of infection and disease are reviewed as they pertain to the fight against AIDS. The relation between AIDS and basic scientific processes is bidirectional in that AIDS may provide important insight into various basic processes and these same processes may also yield information useful to efforts to halt the spread of the disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Epilogue: Psychological interventions in the changing health care systems.

Psychotherapy has utility for a wide variety of circumstances that have significant economic, personal, and social consequences. This special issue is a small attempt to address some of these problems. There are important omissions, such as the frequent use of psychotropic medications in psychotherapy, psychological rehabilitation of patients and families with chronic health problems, and hospice care. The need for establishment of a national policy on how psychotherapy can be used to create more effective and humane solutions to societal problems has been identified. The challenge is how to fund the study of health and other social problems responsive to psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological interventions for arthritis pain management in adults: A meta-analysis.

Context: The psychosocial impact of arthritis can be profound. There is growing interest in psychosocial interventions for managing pain and disability in arthritis patients. Objective: This meta-analysis reports on the efficacy of psychosocial interventions for arthritis pain and disability. Data Sources: Articles evaluating psychosocial interventions for arthritis were identified through Cochrane Controlled Trials, EMBASE, Ovid MEDLINE, and Ovid PsycINFO data sources. Study Selection: Randomized controlled trials testing the efficacy of psychosocial interventions in arthritis pain management were reviewed. Data Extraction: Twenty-seven randomized controlled trials were analyzed. Pain intensity was the primary outcome. Secondary outcomes included psychological, physical, and biological functioning. Data Synthesis: An overall effect size of 0.177 (95% CI = 0.256-0.094) indicated that patients receiving psychosocial interventions reported significantly lower pain than patients in control conditions (combined p = .01). Meta-analyses also supported the efficacy of psychosocial interventions for the secondary outcomes. Conclusions: These findings indicate that psychosocial interventions may have significant effects on pain and other outcomes in arthritis patients. Ample evidence for the additional benefit of such interventions over and above that of standard medical care was found. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Antiretroviral therapy for HIV infection in 1996. Recommendations of an international panel. International AIDS Society-USA

We report on a retrospective study evaluating infectious morbidity associated with totally implantable venous access devices (TIVAD) (Port-A-Cath) in HIV-infected patients. This study of 84 consecutive HIV-infected patients requiring 89 TIVAD between January 1990 and October 1993 was performed in the Department of Infectious Diseases H?pital de l'Institut Pasteur, Paris, France. The total number of catheter days was 11,595. Eighteen of 89 patients with TIVAD (20%) were infected, causing 25 infectious events (25/89: 28%) among 17 different patients (17/84: 20%). The infection rate was 0.22 per 100 catheter days. Mean onset of infection was 82 days. Twenty microorganisms were isolated: Staphylococcus aureus in eight cases (40%), coagulase-negative Staphylococcus in six cases (30%), Streptococcus D faecalis in one case; Gram-negative bacilli were found in five cases (25%). All patients received an intravenous antibiotherapy combined with a local lock treatment in eight cases. Nine TIVAD removals were performed. One death was related to the TIVAD infection. No additional predisposing factor for infection was identified other than the implied condition of the HIV infection. The population and material in this study were homogeneous. The TIVAD infection rate was comparable to other published reports. Prospective evaluation comparing tunneled catheter and TIVAD in HIV-infected patients is needed.