Impact of combination therapies on HIV risk perceptions and sexual risk among HIV-positive and HIV-negative gay and bisexual men.

The availability of improved HIV treatments may prompt reduced concern about HIV and sexual risk. Gay and bisexual men (N?=?554, 17% HIV-positive) completed measures of treatment attitudes, sexual risk, and assumptions regarding the infectiousness of sexual partners. A substantial minority reported reduced HIV concern related to treatment advances. Reduced HIV concern was an independent predictor of sexual risk, particularly among HIV-positive men. In response to hypothetical scenarios describing sex with an HIV-positive partner, participants rated the risk of unprotected sex to be lower if the partner was taking combination treatments and had an undetectable viral load, relative to scenarios with a seropositive partner not taking combination treatments. Prevention efforts must address attitudinal shifts prompted by recent treatment successes, stressing the continued importance of safer sex, and that an undetectable viral load does not eliminate infection risks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anglophone and Francophone managers' perceptions of cultural differences in approaches to work.

Examined the extent to which 600 Anglophone and 188 Francophone managers in a large corporation in Canada believed that members of the 2 groups differed in their approach to and execution of their work. Francophone managers tended to perceive differences, whereas Anglophones showed a slight tendency to perceive similarities. Consistent with previous research, the Francophone managers who perceived differences expressed favorable attitudes toward the differentiating characteristics of their own group and those of Anglophones. In contrast, Anglophone managers who perceived differences evidenced a degree of ethnocentrism, viewing characteristics of their own group favorably and relatively downgrading those of Francophones. The ethnocentrism on the part of Anglophone managers was interpreted as reflecting a predictable response to what they perceive to be threatening changes in intergroup relations in Quebec. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress, expectancies, and vulnerability to substance abuse: A test of a model among homosexual men.

We hypothesize that specific attitudes or expectancies make people vulnerable to responding to stress via alcohol or drugs. This "stress-vulnerability" model was tested among homosexual men, who show elevated rates of substance abuse and have culturally specific stressors and vulnerability. Tension reduction expectancies of alcohol effects had a substantial effect on alcohol and marijuana/drug abuse, as did the use of bars as a social resource. Two stress variables—negative affectivity and discrimination attributable to sexual orientation—also had significant, though more moderate effects. Interactions of the vulnerability measures with the stress variables had significant effects on substance abuse beyond the main effects, supporting the central hypothesis. In a second analysis both simple consumption levels and "high-risk" styles of alcohol or drug use predicted alcohol or drug problems better among vulnerable than among nonvulnerable respondents. These findings strongly supported a general stress-vulnerability model of substance abuse and illustrated several important risk factors in homosexual culture. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Treatment Advocacy Program: A randomized controlled trial of a peer-led safer sex intervention for HIV-infected men who have sex with men.

Objective: Primary care may be an effective venue for delivering behavioral interventions for sexual safety among HIV-positive men who have sex with men (MSM); however, few studies show efficacy for such an approach. We tested the efficacy of the Treatment Advocacy Program (TAP), a 4-session, primary-care-based, individual counseling intervention led by HIV-positive MSM “peer advocates” in reducing unprotected sex with HIV-negative or unknown partners (HIV transmission risk). Method: We randomized 313 HIV-positive MSM to TAP or standard care. HIV transmission risk was assessed at baseline, 6 months, and 12 months (251 participants completed all study waves). We conducted intent-to-treat analyses using general estimating equations to test the interaction of group (TAP vs. standard care) by follow-up period. Results: At study completion, TAP participants reported greater transmission risk reduction than did those receiving standard care, χ2(2, N = 249) = 6.6, p = .04. Transmission risk among TAP participants decreased from 34% at baseline to about 20% at both 6 and 12 months: Transmission risk ranged from 23% to 25% among comparison participants. Conclusions: TAP reduced transmission risk among HIV-positive MSM, although results are modest. Many participants and peer advocates commented favorably on the computer structure of the program. We feel that the key elements of TAP—computer-based and individually tailored session content, delivered by peers, in the primary care setting—warrant further exploration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol Use and High-Risk Sexual Behavior Among Men Who Have Sex With Men: The Effects of Consumption Level and Partner Type.

Alcohol use may increase HIV sexual risk behavior, although findings have varied across study populations and methods. Using event-level data from 1,712 seronegative men who have sex with men, the authors tested the hypothesis that social context would moderate the effect of alcohol consumption on unprotected anal sex (UAS). For encounters involving a primary partner, rates of UAS did not vary as a function of alcohol use. However, consumption of 4 or more drinks tripled the likelihood of UAS for episodes involving a nonprimary partner. Thus, the effects of alcohol vary according to the context in which it is used. Interventions to reduce substance-related risk should be tailored to the demands of maintaining sexual safety with nonprimary partners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A community approach to the recognition of alcohol abuse: The drinking norms of three Montreal communities.

Used a "community" approach to examine how an individual is recognized as having a problem with alcohol abuse. The norms governing normal and problem drinking were assessed in 3 socioeconomically different communities (lower-, middle-, and upper-middle-class) by having 128 respondents rate the average as well as minimum and maximum possible consumption of 4 "types" of drinkers (the respondent him/herself, social drinker, problem drinker, and alcoholic) in each of 4 social contexts (i.e., lunch/workday; evenings, with family; at a social event; while alone). Results indicate that the communities had both shared and idiosyncratic drinking norms. The communities agreed in defining a problem drinker's consumption levels as more dependent upon the social context than a normal drinker's, and differed over their expectancies of different drinkers' average consumption, as well as their ranges of possible consumption. These range differences are interpreted as reflecting the clarity of each community's articulation of its drinking norms, and as having significant implications for the recognition process. (French summary) (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)