Lessons learned from more than two decades of HIV/AIDS prevention efforts: implications for people who are deaf or hard of hearing.

In contrast with the nearly 30 years of HIV/AIDS research with the hearing community, data on HIV infection among persons who are deaf and hard of hearing is primarily anecdotal. Although the few available estimates suggest that deaf and hard of hearing persons are disproportionately affected by HIV infection, no surveillance systems are in place to identify either frequency or mode of HIV infection within this population. Moreover, to date, all empirically validated HIV prevention interventions have relied on communication strategies developed for persons who hear. Therefore, understanding and developing effective prevention methods is crucial for persons who are deaf or hard of hearing. The authors explore (a) factors among this population that may contribute to HIV-related behaviors, (b) four key concepts consistently included in successful interventions, and (c) practical ways in which to use this information to tailor effective intervention strategies for this population.

Effects of quality of life and coping on depression among adults living with HIV/AIDS.

This prospective study examined the effect of maladaptive coping strategies and psychological quality of life (QOL) on depression at two time points in a diverse sample of persons living with HIV/AIDS (N = 85). The use of maladaptive coping strategies to deal with the stress of living with HIV/AIDS, particularly engaging in various kinds of avoidant behaviors, was significantly associated with greater depression at baseline and increased depression at three months. QOL was the single most important predictor of depression. In an effort to develop effective clinical methods aimed at decreasing depression among adults living with HIV, future studies need to focus on improving quality of life and increasing adaptive coping strategies associated with the stress of living with HIV/AIDS.

The changing age of HIV: sexual risk among older African American women living in rural communities.

BACKGROUND: African American women aged 50 and older are disproportionately affected by the HIV/AIDS epidemic. Despite African Americans making up 11% of all older women in the United States, in 2001, they accounted for more than 50% of AIDS cases among older women and more than 65% of HIV cases among older women. Using the AIDS Risk Reduction Model as a conceptual framework, this study investigated HIV risk behavior among older rural African American women (mean age = 58 years). METHODS: A cross-sectional survey was conducted (n = 181) in three rural counties in South Carolina. RESULTS: Most (67%) of the women had at least one sex partner in the past five years, and of these, more than half (59.5%) reported at least one sexual risk behavior. High-risk behavior was associated with less education, lower condom use self-efficacy, more peers who discussed HIV-related risk behavior, and less comfort communicating with partners about sex. CONCLUSIONS: A significant proportion of older African American women living in rural counties are at increased risk for HIV infection, suggesting an urgent need for HIV prevention efforts to target this population.