Implementing packaged HIV-prevention interventions for HIV-positive individuals: considerations for clinic-based and community-based interventions.

Providing efficacious human immunodeficiency virus (HIV) prevention services to HIV-positive individuals is an appropriate strategy to reduce new infections. The Centers for Disease Control and Prevention (CDC) has identified interventions with evidence of efficacy for prevention with positives (PwP). Through its process of disseminating evidence-based interventions (EBIs), CDC has attempted to diffuse four of these interventions into practice. One of these interventions has been diffused to community-based organizations, whereas another has been diffused to medical clinics serving HIV-positive people. A third intervention was originally developed with HIV-positive individuals using methadone, but uptake by methadone clinics has not occurred. A fourth intervention for HIV-positive adolescents and young adults has had disappointing adoption levels. Unique implementation challenges have been encountered in various intervention settings. Lessons learned in the dissemination of the first four PwP interventions will facilitate implementation of three new PwP EBIs currently being packaged for dissemination.

Intimate partner violence and monogamy among women in methadone treatment.

It is now becoming clear how important it is to understand women's HIV risk in the context of their sexual relationships with male partners, particularly among more vulnerable populations of women such as drug-involved women and women with physically abusive partners. Drawing from in-depth interviews with a sample of 38 ethnically diverse women, this study explores the meanings of monogamy and concurrent sexual partnerships in the relationships of women in methadone treatment with a history of physical abuse. Moreover, the ways in which having a history of intimate partner violence influences women's desire and ability to insist on monogamy is addressed. The women's narratives indicated that the majority valued monogamy and reported practicing it; however, many women were indifferent to this ideal or were unable to challenge non-monogamous partners for fear of severe reprisals. In addition, men's suspicions about violations of monogamy on the part of the women often resulted in extreme violence.

Assessing reliability of early adolescent girls' reports of romantic and sexual behavior.

Increasing rates of HIV among urban adolescents have raised concerns about their participation in sexual risk behaviors. The accuracy of adolescents' sexual reports is critical to the assessment of risk, which may later guide the development of public policy, interventions, and education efforts. The data presented here are part of a larger study on a range of sexual behaviors and cognitions believed to be important regarding adolescent girls' sexual choices and decision-making. Our goal here was to assess the test-retest reliability of early adolescent girls' reports of their romantic and sexual experiences. This information will contribute to our limited information base regarding sexuality research with early adolescents. Fifty urban African American and Latina girls between the ages of 12 and 14 years were recruited from community settings around New York City. A battery of sexual behavior and sexual cognition measures was administered by interviewers at two time points separated by a 3-week interval. Results indicated that the girls were highly reliable in reporting their sexual experiences, especially those experiences related to age of first romantic and sexual milestone experiences.

Sibling influence, gender roles, and the sexual socialization of urban early adolescent girls.

This study examined whether older siblings influence early adolescent girls' sexual socialization. Participants were 180 girls, 12 to 14-years-old, from predominantly ethnic minority backgrounds. They completed a battery of interviewer-administered measures assessing a range of sexual cognitions and romantic and sexual behaviors. As predicted, compared with other girls, girls with older brothers placed greater value in becoming a parent, had lower levels of sexual responsivity or interest, and reported smaller age discrepancies between themselves and their partners for their first romantic kiss. Regardless of sibling sex, having older siblings was associated with more restrictive sexual cognitions and behaviors. Findings are interpreted in the context of sexual script theory.

Community violence and children's psychological well-being: does parental monitoring matter?

Poor, inner-city children are exposed to inordinately high rates of community violence. Although the link between exposure to violence and adverse mental health outcomes is well documented, less attention has focused on factors that may buffer children from negative outcomes. Using a sample of 163 4th- and 5th-grade children, this study investigated whether children's perceptions of parental monitoring moderate the relation between children's violence exposure and their psychological well-being, as assessed by depression and hopelessness. Greater exposure to community violence was associated with more symptoms of depression and feelings of hopelessness. Moreover, parental monitoring buffered to a certain extent the relation between violence exposure and psychological functioning. Increased monitoring had a positive impact on the psychological well-being of children who were less exposed to violence; however, as violence exposure increased, the impact of parental monitoring was attenuated.