Intentional abstinence among homeless and unstably housed persons living with HIV/AIDS

Quantifying Sexual Orientation Among Homeless and Unstably Housed Women in a Longitudinal Study: Identity, Behavior, and Fluctuations Over a Three-Year Period

Sexual orientation has been linked to certain health conditions, and yet quantifying sexual orientation in longitudinal studies is challenging. This study examined different methods of accounting for sexual orientation in a cohort study of 300 homeless and unstably housed women followed every 6 months over 3 years. Altogether, 39.7% (n = 119) could be considered sexual minority at one or more time points based on identity and/or behavior; 16.3% (n = 49) reported shifts in sexual identity. Only 24.0% (n = 72) were identified as sexual minority through a single measure of sexual identity, 27.0% (n = 81) were identified with a single measure of identity and behavior, 33.0% (n = 99) were identified through annual measures of identity and behavior, and 22.0%-22.3% (n = 66-67) were identified through latent class analysis including all identity/behavior measures. This study found that sexual fluidity is common in unstably housed women, and many sexual minority women would be missed in longitudinal studies with different methods of accounting for sexual orientation.

Increasing HIV testing among African immigrants in ireland: challenges and opportunities

In 2012, immigrants constitute 63% of new cases of heterosexually transmitted HIV among individuals born outside Ireland. Current strategies to encourage testing can be ineffective if immigrants perceive them as culturally insensitive. We obtained qualitative data to explore challenges to voluntary HIV-testing for immigrants in Ireland. Content analysis was undertaken to identify and describe pertinent themes. Widespread beliefs that HIV is primarily a disease of African immigrants were identified as challenges that constrain access to testing and care. The organization and location of testing services, attitude of health workers, and beliefs regarding mandatory HIV-testing for immigrants seeking access to welfare benefits were also identified. Immigrants in Ireland encounter a variety of structural, cultural and personal constraints to HIV testing. Opportunities exist in the Irish Health system to increase testing among immigrants through greater acknowledgement of cultural sensitivities of immigrant groups.

Anxiety and Depressive Symptoms Among People Living with HIV and Childhood Sexual Abuse: The Role of Shame and Posttraumatic Growth

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.

Sexual health, HIV, and sexually transmitted infections among gay, bisexual, and other men who have sex with men in the United States

The sexual health of gay, bisexual, and other men who have sex with men (MSM) in the United States is not getting better despite considerable social, political and human rights advances. Instead of improving, HIV and sexually transmitted infections (STIs) remain disproportionately high among MSM and have been increasing for almost two decades. The disproportionate and worsening burden of HIV and other STIs among MSM requires an urgent re-assessment of what we have been doing as a nation to reduce these infections, how we have been doing it, and the scale of our efforts. A sexual health approach has the potential to improve our understanding of MSM's sexual behavior and relationships, reduce HIV and STI incidence, and improve the health and well-being of MSM.

HIV infection and women's sexual functioning

OBJECTIVE

To compare sexual problems among HIV-positive and HIV-negative women and describe clinical and psychosocial factors associated with these problems.

DESIGN

Data were collected during a study visit of the Women's Interagency HIV Study (WIHS). The WIHS studies the natural and treated history of HIV among women in the United States.

METHODS

Between October 01, 2006, and March 30, 2007, 1805 women (1279 HIV positive and 526 HIV negative) completed a study visit that included administration of the Female Sexual Function Index. In addition, the visit included completion of standardized interviewer-administered surveys, physical and gynecological examinations, and blood sample collection.

RESULTS

Women with HIV reported greater sexual problems than did those without HIV. Women also reported lower sexual function if they were classified as menopausal, had symptoms indicative of depression, or if they reported not being in a relationship. CD4 cell count was associated with Female Sexual Function Index scores, such that those with CD4

CONCLUSIONS

Given research documenting relationships between self-reported sexual problems and both clinical diagnoses of sexual dysfunction and women's quality of life, greater attention to this issue as a potential component of women's overall HIV care is warranted.

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Key Words

• hiv
• women
• sexual behavior
• sexual problems

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MESH Headings

• Adult
• Arousal
• Depression/epidemiology
• Depression/psychology
• Female
• HIV Infections/psychology
• HIV Seronegativity
• HIV Seropositivity/psychology
• Humans
• Interviews as Topic
• Menopause
• Middle Aged
• Multivariate Analysis
• Orgasm
• Psychology
• Sexual Behavior/psychology
• United States
• Young Adult

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Grants

• K23 AG032870-01A1 NIA NIH HHS
• U01-AI-42590 NIAID NIH HHS
• U01 AI031834 NIAID NIH HHS
• U01 AI035004 NIAID NIH HHS
• U01-HD-32632 NICHD NIH HHS
• P30 AG012857 NIA NIH HHS
• U01-AI-34994 NIAID NIH HHS
• U01-AI-35004 NIAID NIH HHS
• U01-AI-31834 NIAID NIH HHS
• U01 AI034994 NIAID NIH HHS
• K23 AG032870 NIA NIH HHS
• U01 AI034993 NIAID NIH HHS
• UL1 RR024131 NCRR NIH HHS
• U01 AI034989 NIAID NIH HHS
• 5P30 AG 012857 NIA NIH HHS
• U01-AI-34993 NIAID NIH HHS
• U01 AI031834-16 NIAID NIH HHS
• U01-AI-34989 NIAID NIH HHS
• U01 HD032632 NICHD NIH HHS
• U01 AI042590 NIAID NIH HHS

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Affiliation(s)

Tracey E Wilson Department of Community Health Sciences, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA.
Girardin Jean-Louis
Rebecca Schwartz
Elizabeth T Golub
Mardge H Cohen
Pauline Maki
Ruth Greenblatt
L Stewart Massad
Esther Robison
Lakshmi Goparaju
Stacy Lindau

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