Finding the "community" in community-level HIV/AIDS interventions: formative research with young African American men who have sex with men.

Data from 76 qualitative interviews with 18- to 29-year-old African American men who have sex with men (MSM) in Chicago and Atlanta were examined to identify perceptions of "community" and components of a community-level HIV/AIDS intervention. Many men reported feeling marginal to African American and gay White communities because of perceived homophobia and racism. Those who reported feeling part of gay African American communities characterized communities in terms of settings, social structures, and functions, including social support, socialization, and mobility. Despite these positive functions, divisions among groups of MSM, lack of settings for nonsexual interaction with other MSM, lack of leadership, and negative attitudes toward homosexuality may make it difficult for men to participate in activities to alter community contexts that influence behavior. Rather, changing norms, increasing social support, and community building should be part of initial community-level interventions. Community building might identify leaders, create new settings, and create opportunities for dialogue between MSM and African American community groups to address negative perceptions of homosexuality.

"Let us go into the house of the Lord": participation in African American churches among young African American men who have sex with men.

Describes the church involvement of young African American men who have sex with men (MSM). Reports data secured from 76 individual semistructured interviews with men between the ages of 18 and 29 who reported recent sexual behavior with other men in Atlanta and Chicago that revealed high levels of involvement in African American churches and its impact on self-esteem and sexual behavior. Notes that participation in African American churches encourages sexual secrecy and is associated with decreased frequencies of same-sex contacts. Suggests that African American clergy and other church leaders can initiate dialogue with church-going MSM and redirect ministerial efforts to foster inclusive, nurturing religious communities that no longer marginalize these African American men.

Homophobia, self-esteem, and risk for HIV among African American men who have sex with men.

Qualitative data from individual interviews with 18-29 year old African American men, who have sex with men (n = 76) were used to examine the relationship of negative attitudes toward homosexuality, self-esteem, and risk for HIV. Respondents perceived members of their communities as holding negative attitudes toward homosexuality, and many thought the African American community was less accepting of homosexuality than the white community. There was evidence that these negative attitudes are internalized by some of the young African American men themselves. Respondents mentioned several ways that negative attitudes toward homosexuality could lead to lower self-esteem and psychological distress in young gay and bisexual men. In addition, respondents articulated several mechanisms by which low self-esteem and psychological distress might be associated with sexual behaviors that put one at risk for HIV. We concluded that addressing and changing society's negative views of homosexuality are important components of a comprehensive approach to reducing the transmission of HIV, especially among young people in communities of color.

Comparing gay and bisexual men on sexual behavior, condom use, and psychosocial variables related to HIV/AIDS.

Interviews were conducted with 750 men, recruited from a variety of sources in Chicago, who reported sex with men in the past 3 years. Behavioral criteria were used to establish groups of gay and bisexual men. We predicted that gay men, compared to bisexual men, would report more male sexual partners, more experience with receptive sex, and more tolerant attitudes toward homosexuality. The only reliable difference between the gay and bisexual men with respect to number of partners was that gay men were more likely to have had a steady male partner or lover. Gay men were more likely than bisexual men to have engaged in receptive sex, including unprotected receptive anal sex. Bisexual men were more self-homophobic and saw other people as less accepting of same-sex activity. There were no differences between gay and bisexual men in other psychosocial variables. Interventions designed to reduce the transmission of HIV/AIDS need to consider differences in gay and bisexual men's sexual behavior and attitudes toward homosexual behavior.

A comparison of patients' perception of dental care offered by male or female dentists in New Zealand.

Recent increases in women dentists in New Zealand follow similar trends in other Western countries. The career patterns of female dentists, and male dentists' attitudes towards women dentists in New Zealand have been previously studied. The aim of this study was to compare the attitudes and preferences of patients towards dental care offered by either male or female dentists, to determine what influences these preferences, and to discover whether or not these opinions differed between regular or irregular attenders.

Subjective evaluation of a prototype earmuff exhibiting flat and nonlinear attenuation characteristics.

Subjective user responses were obtained for a test earmuff exhibiting approximately flat (uniform) attenuation of about 25 dB from 500 to 8000 Hz for sound pressure levels (SPLs) less than 120 dB. At SPLs above 120 dB, the test earmuff exhibited nonlinear (level-dependent) attenuation characteristics such that noise reduction increased with increasing sound level. The study population consisted of police officers from the Raleigh, North Carolina, Police Department as they were performing arms requalification by executing a series of firing programs during two sequential and identical relays. The study subjects wore either the test earmuff or a comparable conventional earmuff during the first relay, then the alternate protector for the second relay with the order counterbalanced. Results indicated a significant preference for the test earmuff in three comparison areas: comfort, perceived hearing protection, and speech understanding. The study demonstrates that ammunition type and level of noise exposure contributed significantly to a preference in favor of the test earmuff. The subjects who used the quietest of the ammunition types rated the test earmuff significantly better than the remaining subjects with respect to speech understanding.

An examination of the relation of individual difference variables to loneliness.

This study investigated the relation of five individual difference variables (extroversion, depression, self-esteem, neuroticism, and attitude toward others) to loneliness. The relative contributions of two different models that might explain these relations were examined. One model suggests that individual difference variables are related to loneliness through the mediation of social network variables; that is, individual difference variables may reduce people's motivation and/or ability to build and maintain social relationships, which in turn leads to loneliness. The second model, the cognitive bias model, states that both the individual difference variables and loneliness are influenced by the same intrapersonal, cognitive processes. Some people are prone to negative affect and tend to evaluate themselves and their relationships negatively. The relations of self-esteem, neuroticism, and depression to loneliness were hypothesized to reflect the cognitive bias model, while extroversion and attitudes toward others were hypothesized to be related to loneliness through the mediation of social network variables. Eighty-two female and 42 male adults completed measures of loneliness and the five individual difference variables, as well as an instrument assessing their social networks. The results indicated partial support for both models for each of the individual difference variables. Together, the two models did a good job of explaining the correlations of the individual difference variables and loneliness. The implications of these findings, as well as their relation to previous research, are discussed.

The inventory of socially supportive behaviors: dimensionality, prediction, and gender differences.

The nature of social support as measured by the Inventory of Socially Supportive Behaviors (ISSB) was explored in the study. The results of a principal components analysis suggest that it is appropriate to use the ISSB as a global measure of a unidimensional construct. The components that emerged were interpretable, however, and are consistent with the types of social support that have been cited in the literature. Males and females do not differ in overall social support as measured by the ISSB, but females report receiving more emotional support than males do. Social network variables predicted ISSB scores for males but not for females. The network variable that predicted social support most strongly was the number of people a respondent felt close to and could confide in or turn to for help in an emergency. The meanings and implications of these findings are discussed.

The surgical treatment of traumatic rupture of the aortic valve: report of a case after blunt chest trauma.

An elderly patient with traumatic aortic valvular insufficiency was treated surgically with valve replacement, the preferred method of treatment, since prognosis is poor without timely surgical therapy. Further emphasis should be given to early diagnosis of this lesion.