An intervention for changing high-risk HIV behaviors of African American drug-dependent women.

The purpose of this study was to test the effectiveness of an AIDS education intervention for methadone-dependent, African American women. The women were randomly assigned to experimental (n=107) or control (n=97) group. The experimental group participated in a peer counseling and leadership training program conducted by two experienced nurse counselors over an 8-week period, followed by 8 weeks of reinforcement. The program was designed to reduce AIDS high-risk sexual behavior, increase self-esteem, decrease depressive affect, and increase the women's community-based AIDS prevention communication activities. A total of 130 women completed all phases of the study, including longitudinal Posttests at 2, 4, and 7 months after enrollment. Compared to the control group, there were statistically significant differences in three of the outcomes for the experimental group: The experimental group reported an increased number of safer sexual behaviors (p=.029), showed decreases in depression (p=.001), and reported engaging in more AIDS-related, community-based communication activities regarding prevention (p=.005).

AIDS prevention in high-risk African American women: behavioral, psychological, and gender issues.

A three-year longitudinal intervention study was implemented to reduce high-risk drug and sexual behaviors in methadone-dependent African American women. Participants were recruited from four inner-city methadone maintenance programs and randomly assigned either to an eight-week peer counseling and leadership training group or to a control group. The 107 trainees and 97 controls completed pretests and posttests at two, four, and seven months. This paper focuses on final data related to the subjects' sexual beliefs, attitudes, knowledge, and behaviors that put them at risk for HIV/AIDS. Reasons for not using condoms are categorized and discussed. Despite the women's awareness of the seriousness of AIDS, perceived powerlessness to negotiate condom use, negative attitudes about the use of condoms, influence of drugs, and unavailablility of condoms interfered with safer sex practices. The inability of education alone to prevent many high-risk sexual behaviors suggests that more serious consideration be given to expanded distribution of condoms as well as needle exchange programs and legalization of illicit drugs.

PIP: The US Centers for Disease Control report that although African-American women comprise only 12% of the US female population, they account for 56.9% of AIDS cases in women. In 1994, 41% of women with AIDS reported IV-drug use and 38% reported heterosexual contact with a partner at risk for or known to have HIV infection or AIDS. Findings are presented from a 3-year study conducted to assess and reduce high-risk drug and sex behavior among methadone-dependent African-American women in Baltimore, Maryland. Through random assignment, 107 women received 8 weeks of peer counseling and leadership training, and 97 women formed the control group. The women were 20-59 years old of mean age 35.5. 84-90% were unemployed and 16% had been homeless within the preceding 6 months. Subjects completed pretests and post-tests at 2, 4, and 7 months. Despite the women's awareness of the seriousness of AIDS, their perceived powerlessness to negotiate condom use, negative attitudes about condom use, the influence of drugs, and the unavailability of condoms interfered with the practice of safer sex behavior. The authors believe that the inability of education alone to prevent many high-risk sexual behaviors is cause to give more serious consideration to expanding the distribution of condoms as well as needle exchange programs and the legalization of currently illicit drugs.

Collaboration as a strategy for acquired immunodeficiency syndrome prevention.

An eight-session training model used a social interactive framework to combine theoretical and methodological aspects of peer counseling, cross-cultural communication, and transcultural nursing, with a conviction that the participants (volunteers from an ongoing, urban methadone maintenance program) had significant strengths on which to build. The objective was to assist urban, drug dependent black women in taking control of their own lives through collaboration with health care professionals to develop and promote culturally acceptable behavioral alternatives related to reduction of risk for human immunodeficiency virus. The collaborative approach focused on rewards of behavioral change and minimized attention to prevention of negative behaviors, while openly valuing input from the women who are potential health promoters in their own communities. Evaluation of the Peer Counseling Leadership Training Program suggested that the approach facilitated personal risk-reducing behavioral change, improved self esteem, and successfully promoted involvement in community-based prevention efforts.

Strategies for AIDS prevention: leadership training and peer counseling for high-risk African-American women in the drug user community.

A culturally congruent training program to promote HIV risk-reduction behaviors was implemented in a convenient sample of 9 African-American women in an urban methadone treatment program. At each of eight peer counseling and leadership training (PCLT) program sessions, the transmission and prevention of AIDS were discussed while emphasizing enhancement of participants' self-esteem, confidence, and control over high-risk behaviors. The results indicate that support of the women helped develop their sense of purpose and self-worth, reduced sexual and drug use practices associated with risk for HIV and AIDS infection, and promoted assumption of leadership roles and dissemination of accurate AIDS-related information in their communities. It was apparent that knowledge alone does not change behavior if it conflicts with established norms, values, beliefs, and life-styles and that individuals who have a sense of personal control are more willing to explore alternative lower-risk behaviors.

A controlled study of the effect of prepared childbirth classes on obstetric outcomes.

After the development and initiation of prepared childbirth classes in a large, inner-city hospital, a case-controlled study was designed to assess their impact on obstetric outcomes. Prepared couples were matched with nonattenders on six variables: race, patient status (clinic or private), parity, marital status, age, and socioeconomic status. Statistically significant differences between the groups were found. Prepared couples were more likely to receive little or no pain medication and less conduction anesthesia than controls. Consequently, 79 percent of their deliveries were spontaneous, compared to 51 percent for controls (P less than 0.001). Despite the increased pushing ability of the class attenders, over 80 percent of women in both groups had an episiotomy, which was, in turn, significantly associated with a second-, third-, or fourth-degree laceration, thus bringing into question its routine use. Further studies to identify additional factors associated with positive obstetric outcomes are warranted.

Photoinhibition at low temperature in chilling-sensitive and -resistant plants.

Photoinhibition resulting from exposure at 7 degrees C to a moderate photon flux density (300 micromoles per square meter per second, 400-700 nanometers) for 20 hours was measured in leaves of annual crops differing widely in chilling tolerance. The incidence of photoinhibition, determined as the decrease in the ratio of induced to total chlorophyll fluorescence emission at 693 nanometers (F(v)/F(max)) measured at 77 Kelvin, was not confined to chilling-sensitive species. The extent of photoinhibition in leaves of all chilling-resistant plants tested (barley [Hordeum vulgare L.], broad bean [Vicia faba L.], pea [Pisum sativum L.], and wheat [Triticum aestivum L.]) was about half of that measured in chilling-sensitive plants (bean [Phaseolus vulgaris L.], cucumber [Cucumis sativus L.], lablab [Lablab purpureus L.], maize [Zea mays L.], pearl millet [Pennisetum typhoides (Burm. f.) Stapf & Hubbard], pigeon pea [Cajanus cajun (L.) Millsp.], sesame [Sesamum indicum L.], sorghum [Sorghum bicolor L. Moench], and tomato [Lycopersicon esculentum Mill.]). Rice (Oryza sativa L.) leaves of the indica type were more susceptible to photoinhibition at 7 degrees C than leaves of the japonica type. Photoinhibition was dependent both on temperature and light, increasing nonlinearly with decreasing temperature and linearly with increasing light intensity. In contrast to photoinhibition during chilling, large differences, up to 166-fold, were found in the relative susceptibility of the different species to chilling injury in the dark. It was concluded that chilling temperatures increased the likelihood of photoinhibition in leaves of both chilling-sensitive and -resistant plants. Further, while the photoinhibition during chilling generally occurred more rapidly in chilling-sensitive plants, this was not related directly to chilling sensitivity.

Stress tolerance and stress-induced injury in crop plants measured by chlorophyll fluorescence in vivo: chilling, freezing, ice cover, heat, and high light.

The proposition is examined that measurements of chlorophyll fluorescence in vivo can be used to monitor cellular injury caused by environmental stresses rapidly and nondestructively and to determine the relative stress tolerances of different species. Stress responses of leaf tissue were measured by F(R), the maximal rate of the induced rise in chlorophyll fluorescence. The time taken for F(R) to decrease by 50% in leaves at 0 degrees C was used as a measure of chilling tolerance. This value was 4.3 hours for chilling-sensitive cucumber. In contrast, F(R) decreased very slowly in cucumber leaves at 10 degrees C or in chilling-tolerant cabbage leaves at 0 degrees C. Long-term changes in F(R) of barley, wheat, and rye leaves kept at 0 degrees C were different in frost-hardened and unhardened material and in the latter appeared to be correlated to plant frost tolerance. To simulate damage caused by a thick ice cover, wheat leaves were placed at 0 degrees C under N(2). Kharkov wheat, a variety tolerant of ice encapsulation, showed a slower decrease in F(R) than Gatcher, a spring wheat. Relative heat tolerance was also indicated by the decrease in F(R) in heated leaves while changes in vivo resulting from photoinhibition, ultraviolet radiation, and photobleaching can also be measured.

Tolerances of wild potato species from different altitudes to cold and heat.

The ability of wild potatoes (Solanum spp.) to adapt to potentially stressful environmental temperatures was investigated by measuring the cold and heat tolerances of plants grown near sea-level in Lima following collection of tubers from plants growing naturally at altitudes ranging from 450 to 4,200 m. Relative cold tolerance was measured in leaves stored at 0°C by the decrease in the induced rise of chlorophyll fluorescence. Similarly, changes in chlorophyll fluorescence were used to determine the relative heat tolerance of leaves heated at 41°C for 10 min. With increasing altitude, the cold tolerance of different species tended to increase and conversely, heat tolerance decreased. However, these two genotypic adaptations were not closely correlated and appear to vary independently of each other in response to climate.

Heat tolerance and cold tolerance of cultivated potatoes measured by the chlorophyll-fluorescence method.

Heat and cold tolerances were determined for 13 clones of the commonly cultivated potato, Solanum tuberosum L. Five clones were considered to be adapted to warm climates and the others to cool climates only in terms of their ability to produce tubers. The decrease in the rate of the induced rise in chlorophyll fluorescence after heating leaves at 41°C for 10 min was used to measure relative heat tolerance, and the decrease following chilling at 0°C was used to measure relative cold tolerance. The warm-adapted clones all showed enhanced heat tolerance compared with the cool-adapted clones. Higher heat tolerance was also correlated with a greater tolerance towards a cold stress of 0°C and it is suggested that the warm-adapted clones were selections showing an increased generalized capacity to withstand environmental stresses of several kinds rather than a specific genotypic adaptation to tolerate warm temperatures. Heat and cold tolerances were also determined for several other species of potato cultivated in the Andean region of South America. Of these, S. phureja, which is found at low altitudes on the eastern slopes of the Andes, showed a tolerance to heat comparable to that of the warm-adapted clones of the common potato, the two most heat tolerant of which contained some phureja in their parentage. Diploid and triploid species of cultivated potatoes were considerably more cold tolerant than the clones of the common potato, a tetraploid. The genetic variability for heat and cold tolerance in cultivated and wild potatoes is discussed in relation to increasing the tolerance of the potato to these stresses.

Tolerance of Borya nitida, a poikilohydrous angiosperm, to heat, cold and high-light stress in the hydrated state.

Borya nitida Labill., a plant able to colonize rock outcrops and shallow sands in areas of high incident solar radiation in Western Australia, was examined for its tolerance to extremes of temperature, and to intense visible radiation. Stress injury to the leaves from heat, chilling or photoinhibitory light was followed by the decrease in in-vivo variable chlorophyll fluorescence. Heat injury was also ascertained by an increase in the "constant" fluorescence. Borya nitida leaves were extremely heat tolerant when heated at 1° C min(-1). In-vivo variable chlorophyll fluorescence was detectable up to 55° C, several degrees higher than either maize or barley which are, respectively, adapted to warm and cool climates. An increase in "constant" fluorescence occurred above 50° C in B. nitida. This compares with values in the literature of 48-49° C for three desert plants from Death Valley, California, and 44-48° C for ten species of tropical plants. Unlike the Death-Valley plants, the high degree of heat tolerance found in B. nitida did not require prior acclimation by growth at high temperatures. Borya nitida was also tolerant of a chilling temperature of 0° C. Plants grown at a low photon fluence rate (120 µmol m(-2)s(-1)) were irreversibly photoinhibited by light at 650 µmol m(-2)s(-1). Plants grown in sunlight resisted photoinhibition; however, the capacity to withstand photoinhibition was no greater than that of plants from less extreme environments.