Validation of the Trauma Bonding Scale for Adults© in Kenya.

Recently validated among a sample of young adults in the United States, the Trauma Bonding Scale for Adults© is a much-needed instrument for assessing trauma bonding, which refers to the emotional attachment that often develops between perpetrators and victims of violent and exploitive crimes and is common among survivors of sex trafficking. To assess its utility with other populations, this study aimed to validate the Trauma Bonding Scale for Adults© with a sample of young adults in Kenya. An anonymous survey containing demographic items, the Trauma Bonding Scale for Adults©, and 12 items from an open-source measure of posttraumatic stress disorder was administered to 538 young adults aged 18 to 29 in Kenya using Qualtrics XM. Findings from an analysis of psychometric properties suggest that the Trauma Bonding Scale for Adults© is a valid and reliable measure of trauma bonding that may be useful in a global context.

Factors affecting COVID-19's mental health impact on college students in the southeastern United States.

Emerging evidence confirms COVID-19's negative impact on college students' mental health; however, more research is needed to identify factors that promoted or hindered college students' mental health early in the pandemic. This exploratory study addressed this need. Participants were 697 students attending a large, state, urban university in the southeastern United States. Using a cross-sectional survey design, participants completed an anonymous, online survey assessing socio-demographic variables, mental health issues, and activities during the lockdown period in 2020. Findings suggest college students in the southeastern US who were women or transgender men and had pre-existing mental health conditions, fewer routine activities, and high exposure to COVID-19 news reported more mental health problems early in the pandemic. Students who exercised daily had fewer symptoms of anxiety and post-traumatic stress than students who exercised monthly, but there were no differences in emotional responses to COVID-19 based on exercise frequency. Tailored strategies to address college students' needs in response to the current or future pandemics are needed and should take into consideration factors that promote or hinder mental health. Patient or Public Contribution: College students were participants in this study. College students who were not participants in this study assisted with the implementation of this study.

Interprofessional collaboration: Ethical considerations for school psychologists.

To meet the diverse needs of school-aged children, school psychologists often must collaborate with other professionals within and outside the school setting. Despite potential benefits, challenges exist related to interprofessional collaboration, including ethical challenges. This article explores some of the most salient ethical dilemmas that school psychologists are likely to face when collaborating with other professionals. Specifically, ethical issues related to competence, multiple relationships, informed consent/assent, privacy/confidentiality, assessment, and therapy are examined. Using vignettes, recommendations for navigating common ethical issues that may arise when engaging in interprofessional collaboration are offered. Suggestions are contextualized within the ethical principles and standards outlined in the American Psychological Association's Ethical Principles of Psychologists and Code of Conduct (2017) and the National Association of School Psychologists Professional Standards (2020), which includes the Principles for Professional Ethics. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Adverse Childhood Experiences among a Sample of Youth Living with HIV in the Deep South.

The southern region of the United States, often referred to as the Deep South, is disproportionately affected by HIV. In fact, the highest rates of new HIV infections occur in the Deep South. Approximately one in five new HIV infections are among youth. Youth living with HIV (YLWH) have several behavioral health risks, including co-occurring mental health and substance abuse disorders, which negatively affect medication adherence, contribute to less engagement in HIV care, and result in poor health outcomes. Research suggests that adverse childhood experiences (ACEs) contribute to HIV risk behaviors and that people living with HIV may be more vulnerable to the negative health outcomes and adverse effects of stressors. Using existing program evaluation data, we examined data from 41 YLWH aged 17-24 screened for ACEs in an integrated care setting. Most participants were Black/African American young men who identified as homosexual, bisexual, or questioning, and who acquired HIV behaviorally. Approximately, one-third of YLWH screened positive or in the high-risk range on an ACEs screener. Scores fell in the intermediate range for nearly half of the sample. Results did not reveal a significant relationship between ACEs and HIV biological indicators. In this paper, we describe these findings and the importance of incorporating trauma-informed approaches into HIV prevention and treatment programs targeting youth in the Deep South.

The Biopsychosocial Impact and Syndemic Effect of COVID-19 on Youth Living with HIV in Kenya.

COVID-19's rapid emergence as a biological and psychosocial threat has affected people globally. The purpose of this qualitative study, which was guided by syndemic theory and the biopsychosocial framework, was to examine the impact of COVID-19 on youth living with HIV (YLWH) in Kenya. Seven virtual focus groups and two in-depth interviews were conducted with 15 YLWH aged 18-24, 13 youth affected by HIV aged 18-24, and 12 HIV healthcare providers living in Nakuru and Eldoret, two of Kenya's largest cities. Data were analyzed using qualitative content analysis, which was guided by a descriptive phenomenological approach. Findings provided information about the problems and needs of YLWH as well as potential solutions for mitigating COVID-19's biopsychosocial impact and syndemic effect on YLWH in Kenya. A variety of individual, community, healthcare, and government issues were identified including but not limited to concerns about psychosocial functioning; economic stability; access to medical treatment and medication; the availability of goods and services; patient education; and the dissemination of accurate information. These findings have important implications for addressing the ongoing and long-term impact of the pandemic on YLWH in resource-limited settings through research, policy, and practice.

Ethical Considerations for Parent-Adolescent Dyadic Research.

Over the last few years, the use of dyadic research methods has expanded considerably. One area that has benefited from this type of research is the study of the family unit, particularly parent-adolescent dyads. Dyadic research allows investigators to assess relationship dynamics, processes, and congruences within a family unit, as well as the distinct experiences of each member of the dyad. However, like all emerging and expanding areas of human subjects research, parent-adolescent dyadic research faces several ethical challenges. Given the advantages of parent-adolescent dyadic research for examining family relational processes, this article addresses ethical challenges experienced by dyadic researchers that often temper interests in applying these approaches. Drawing on the scholarly literature and the authors' experiences conducting parent-adolescent dyadic research, we discuss heightened and unique ethical challenges that arise in this area of inquiry and provide recommendations on how to best navigate those issues.

COVID-19 Adaptations for Health Service Psychology Internship Training in a Medical School.

Health service psychology internship directors confronted a myriad of training challenges in response to the COVID-19 pandemic. Specifically, internship training directors were tasked with ensuring that interns received appropriate training in each of the nine profession-wide competency (PWCs) areas while also ensuring the physical and emotional well-being of staff and trainees. The purpose of this paper is to describe one internship's approach to adapting the nine PWCs during COVID-19 in the context of an academic medical setting. Successes and challenges associated with training adaptations in the context of each of the nine PWCs will be shared along with considerations for improving academic medical training programs' ability to support interns' educational goals and training requirements throughout and following the COVID-19 pandemic.

Exploring the Impact of Religion, Superstition, and Professional Cultural Competence on Access to HIV and Mental Health Treatment Among Black Sub-Sahara African Communities in the English City of Birmingham.

HIV and mental health are sensitive subjects among Black Sub-Saharan African (BSSA) communities despite the disproportionate impact of HIV among this population and high comorbidity between HIV and mental disorders. This study explored the impact of religion, superstition, and professional cultural competence on access to HIV and mental health services among BSSA communities in the English city of Birmingham. Researchers utilised explorative qualitative methods. Specifically, 12 focus groups were conducted followed by a semi-structured interview with a member from each focus group. Data were analysed using a thematic approach guided by the four phases of the silences framework. Results suggest that religion, superstition, and professional cultural competence affect access to HIV and mental health services among BSSA communities. Findings indicate a need to educate religious leaders on the impact of HIV and mental health stigma as well as a need for cultural competence training among health professionals.

Bijou: Engaging Young MSM in HIV Care Using a Mobile Health Strategy.

Young men who have sex with men (YMSM) living with HIV experience challenges with retention in care, which negatively affects viral suppression. To address this, researchers piloted Bijou, a program designed to provide health education through electronically delivered behavior and risk reduction modules. Participants were 29 YMSM aged 19-24 living with HIV from the southeastern US. Participants completed pre, post, and 3-month follow-up (3MFU) surveys assessing knowledge, intervention acceptability, satisfaction, self-efficacy, ehealth literacy, and usability. Findings revealed significant improvement in knowledge and e-health literacy from pre-test to post-test but lost significance at 3MFU. Self-efficacy scores did not show significant differences from pre-test to post-test or 3MFU. Participants who completed all modules considered Bijou usable and acceptable; however, many did not complete the program. Findings suggest a need for adaptations to promote knowledge retention, e-health literacy, engagement over time, and research with a larger, more representative sample.

Challenges to the conceptualization and measurement of resilience in HIV research.

The purpose of this study was to evaluate the conceptualization and measurement of resilience in HIV research. Terms related to resilience and HIV were searched in three databases to identify peer-reviewed research articles. Of the 156 articles identified, 49 were included in the analyses. Applied thematic analysis was used to analyze the definitions and measurement of resilience. Articles were reviewed independently by two raters to establish inter-rater reliability. Six recurring themes were identified in the definitions of resilience: adaptation, positive mental health symptoms, the absence of negative mental health symptoms, hardiness, coping, and the ability to "bounce back". Among the articles examined, 14 measures were used to assess resilience, half of which were indirect. These findings help make sense of the available literature on resilience and highlight the importance of clearly operationalizing resilience and measuring it in a way that is congruent with its definition in future HIV research studies.

The Impact of the SEERs Project on HIV Testing in Kenya.

Compared to other key populations, adolescents living in sub-Saharan Africa experience a high HIV disease burden. To address this, organizations have implemented a variety of youth-oriented HIV prevention strategies, including the HIV SEERs Project. SEERs is an innovative, community-based program designed with and for youth in Kenya to reduce HIV stigma (a known barrier to HIV testing), and increase treatment and retention in care. While preliminary research has demonstrated SEERs efficacy for increasing HIV knowledge and decreasing stigma, information about its efficacy as a means to increase HIV testing has been limited to assessing behavioral intentions. To address this limitation, SEERs facilitators partnered with 20 local HIV agencies in 2018 to offer on-site HIV testing during SEERs programming. The purpose of this article is to examine the impact, as well as the benefits and challenges of SEERs programming on HIV testing and linkage to care. SEERs facilitators collected and reported the following data monthly over the course of the year: number of locations for SEERs programming, number and age range of SEERs attendees, number of attendees who screened for HIV and, among those, the number who tested positive and were linked to care. Facilitators also provided written descriptions of the benefits and challenges of implementing the SEERs programming. We analyzed HIV testing data using descriptive statistics and used qualitative data to describe facilitators' perceptions of the benefits and challenges of implementing the SEERs program. We discuss the contributions of these findings to the existing literature and explore future directions.

Gender Differences in Psychosocial Predictors of Sexual Activity and HIV Testing Among Youth in Kenya.

Sub-Saharan Africa (SSA) carries a disproportionate burden of HIV in the world relative to its population. Youth are at particular risk. Understanding HIV risk factors, as well as factors affecting HIV testing among SSA youth, is important given that HIV testing, linkage to care, and viral suppression are part of the global strategy to end HIV. Because young women face disparate sexual and reproductive health outcomes, exploring gender differences related to HIV risk, and testing is vital. Using existing program evaluation data from a larger project, the purpose of this study was to explore gender differences related to sexual activity and HIV testing among youth in SSA. Participant data from 581 youth ages 13-24 in Kenya was analyzed using descriptive statistics, analysis of covariance, and binomial logistic regression. Findings revealed that young men were more likely to report sexual activity than young women. Age was a predictor of sexual activity for all youth. However, among psychosocial variables, depression predicted sexual activity for young women while stress predicted sexual activity for young men. Although there were no gender differences in HIV testing after controlling for demographic and psychosocial variables, there were some differences between young women and young men with regard to predictors of HIV testing. Age and full-time self-employment predicted HIV testing among young women, while part-time self-employment, education, and substance abuse risk predicted HIV testing among young men. Findings suggest a need for gender and youth friendly strategies for addressing the HIV treatment cascade and care continuum.

The Impact of COVID-19 on HIV Treatment and Research: A Call to Action.

The impact of the COVID-19 pandemic is far reaching, with devastating effects on individuals, communities, and societies across the world. People with chronic health conditions may be at greater risk of contracting or experiencing complications from COVID-19. In addition to illness or death for those who contract the virus, the physical distancing required to flatten the curve of new cases is having a negative impact on the economy, the effects of which intersect with mental health and other existing health concerns, thus affecting marginalized communities. Given that HIV also has a disproportionate impact on marginalized communities, COVID-19 is affecting people with HIV (PWH) in unique ways and will continue to have an impact on HIV research and treatment after the COVID-19 crisis passes. Using the biopsychosocial framework to contextualize the impact of COVID-19 on PWH, the purpose of this review article is to: (1) outline the similarities and differences between the COVID-19 and HIV pandemics; (2) describe the current and future impact of COVID-19 on PWH; and (3) outline a call to action for scientists and practitioners to respond to the impact of COVID-19 on HIV prevention and treatment.

Ethical considerations for psychologists in the time of COVID-19.

Psychologists are in a position to respond to the COVID-19 pandemic through research, practice, education, and advocacy. However, concerns exist about the ethical implications associated with transitioning from face-to-face to online or virtual formats as necessitated by stay-at-home orders designed to enforce the social distancing required to flatten the curve of new COVID-19 cases. The purpose of this article is to review potential ethical issues and to provide guidance to psychologists for ethical conduct in the midst of the current crisis and its aftermath. In addition to contextualizing relevant ethical considerations according to the principles and standards of the current American Psychological Association's ethics code, vignettes are presented to exemplify the ethical dilemmas psychologists in various roles may face when responding to COVID-19 and to offer suggestions and resources for resolving potential conflicts. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Self-Disclosure of HIV Status Among Youth Living with HIV: A Global Systematic Review.

Self-disclosure of HIV serostatus by youth has been considered an essential component of HIV prevention and medication adherence efforts. Therefore, a comprehensive investigation of disclosure goals, processes, and outcomes is warranted. We conducted a global systematic review in accordance with the 2015 Preferred Items for Reporting Systematic Reviews and Meta-Analysis tool to assess HIV self-disclosure among youth ages 13-24. We identified 5881 articles during our initial search. After screening titles and abstracts and examining articles in greater detail, 33 studies (35 articles) were included in the synthesis. The disclosure process model was used to highlight antecedent goals to self-disclosure including common avoidance goals such as fear of rejection and isolation. While disclosure was associated with negative and positive emotional outcomes and improved medication adherence, there remain concerns regarding the impact of self-disclosure on sexual behaviors. Implications for practice and future directions for research are presented.PROSPERO registration number: CRD42018097250.

Health Knowledge and Adherence as Predictors of Viral Burden and CD4+ T-Cell Count in Youth and Young Adults Living With HIV.

Health literacy influences HIV treatment for youth and, thus, is a research priority. We explored health knowledge and self-reported adherence, as indicators of health literacy, among youth living with HIV (YLWH) and the association between health literacy and health outcomes. A total of 102 YLWH ages 13-25 years participated in the study. Participants completed the Brief Estimate of Health Knowledge and Action-HIV Version; CD4 T-cell counts and viral loads were extracted from participant medical records. Participants had a moderate amount of HIV knowledge, and most reported taking their medications under most conditions. Decreasing action scores were statistically associated with an increased likelihood of having a detectable viral load. Health literacy is an important factor that should be addressed by practitioners working with YLWH. More research is needed to determine the best way to measure and improve health literacy.

HIV, confidentiality, and duty to protect: Considerations for psychotherapists in the age of treatment as prevention.

Confidentiality and duty to protect are complex issues for psychotherapists treating clients with HIV. The application of the Tarasoff ruling to situations involving HIV has long been debated with questions about how the Tarasoff principles of identifiability of the victim, foreseeability of harm, and necessary protective action apply to HIV within the context of psychotherapeutic relationships. The complexity of these debates is compounded by advances in HIV medicine including the availability of antiretroviral therapy and pre- and postexposure prophylaxis in addition to the current state of knowledge about treatment as prevention. The purpose of this article is to revisit Chenneville's (2000) decision-making model on HIV, confidentiality, and duty to protect in the age of pre- and postexposure prophylaxis and antiretroviral therapy. This revised model may serve as a critical framework for psychotherapists providing services to clients with HIV. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Preliminary Findings From the HIV SEERs Project: A Community-Based Participatory Research Program to Reduce HIV Stigma Among Youth in Kenya.

Worldwide, an estimated 4 million youth, ages 15-24 years, are living with HIV. Youth in Kenya experience a high HIV disease burden. HIV-related stigma is a known barrier to HIV prevention. We evaluated the HIV Stigma-reduction through Education, Empowerment, and Research (SEERs) Project, a conceptually driven program that emerged from community-based participatory research and was designed with and for youth ages 13-24 years in Kenya. We analyzed existing evaluation data from 641 SEERs participants who completed pre-, post-, and 3-month follow-up surveys to evaluate changes in HIV knowledge and stigma. Findings revealed a significant increase in HIV knowledge and a significant decrease in HIV-related stigma over time. Despite strong preliminary evidence, research is needed to refine the program and better determine its effectiveness using a randomized controlled trial. Programs such as SEERs can be used in Kenya and other low- to middle-income countries to improve HIV-related health outcomes.