"In my house": laying the foundation for youth HIV prevention in the Black church.

BACKGROUND: This article describes the process our community-academic partnership used to lay the groundwork for successful implementation of an adolescent-focused, evidence-based HIV/AIDS prevention curriculum in two Black churches. OBJECTIVES: We highlight the challenges encountered and lessons learned in building a relationship with two churches, garnering the pastor's support, and implementing the curriculum within church youth groups. METHODS: We engaged a Community Advisory Board (CAB) made up of youth, parents, and diverse faith leaders to ensure community relevance and guide project development, implementation, and evaluation. LESSONS LEARNED: Using a community-based participatory research (CBPR) approach helped us to (1) engage diverse, intergenerational community members, (2) initiate a "culturally humble" process to build relationships with faith leaders, (3) remain responsive to stakeholder concerns, and (4) open the door to HIV prevention in the Black church. CONCLUSIONS: Finding effective and responsive ways to implement HIV/AIDS prevention in faith settings is facilitated by engaging diverse partners throughout the research process.

Patterns of Violence Exposure and Sexual Risk in Low-Income, Urban African American Girls.

OBJECTIVE: This study examined the relationship between violence exposure and sexual risk-taking among low-income, urban African American (AA) adolescent girls, considering overlap among different types and characteristics of violence. METHODS: AA adolescent girls were originally recruited from outpatient mental health clinics serving urban, mostly low-SES communities in Chicago, IL as part of a two-year longitudinal investigation of HIV-risk behavior. A subsequent follow-up was completed to assess lifetime history of trauma and violence exposure. The current study (N=177) included violence exposure and sexual risk behavior reported at the most recent interview (ages 14-22). Multiple regression was used to examine combined and unique contributions of different types, ages, settings, and perpetrators or victims of violence to variance in sexual risk. RESULTS: More extensive violence exposure and cumulative exposure to different kinds of violence were associated with overall unsafe sex, more partners, and inconsistent condom use. The most significant unique predictors, accounting for overlap among different forms of violence, were physical victimization, adolescent exposure, neighborhood violence, and violence involving dating partners. CONCLUSIONS: These findings put sexual risk in the context of broad traumatic experiences but also suggest that the type and characteristics of violence exposure matter in terms of sexual health outcomes. Violence exposure should be addressed in efforts to reduce STIs among low-income, urban African American girls.

Cognitive-behavioral treatment for posttraumatic stress disorder in children and adolescents.

Several cognitive-behavioral therapy (CBT) approaches are available for treating child and adolescent posttraumatic stress disorder (PTSD). These treatments include common elements (eg, psychoeducation, gradual exposure, relaxation). This review (1) delineates common elements in CBT approaches for treating child and adolescent PTSD; (2) provides a detailed review of three CBT approaches with substantial evidence of effectiveness; and (3) describes promising practices in the area of CBT approaches to treating child and adolescent PTSD. Cultural and implementation considerations are also included.

The relationship between condom-related protective behavioral strategies and condom use among college students: global- and event-level evaluations.

This study evaluated the relationship between condom-related protective behavioral strategies (PBS; including those that require active behavior and mental planning) and condom use at both global and event levels. College students (N = 623; 57.8% female) completed self-report measures of condom-related PBS, as well as drinking and sexual behavior. Logistic regression findings indicated that students who reported greater use of condom-related PBS were more likely to discuss their and their partner's HIV status, sexually transmitted infection (STI) history (other than HIV), and protection against STIs (such as HIV and other STIs) the first time they had sex with their most recent vaginal sexual partner. Logistic regression findings also indicated that more frequent use of condom-related PBS was associated with being more likely to use a condom during the most recent vaginal sexual experience. Zero-inflated negative binomial regression results showed that condom-related PBS predicted condom non-users and that condom-related PBS were associated with increased use of condoms during sexual behavior in the previous three months. These results extend prior research by demonstrating that both active and mental planning condom-related PBS are associated with condom use at both the global and event levels, which suggests that condom-related PBS may be useful to incorporate in interventions targeting risky sexual behavior among young adults.

Marijuana motives: young adults' reasons for using marijuana.

Previous research has evaluated marijuana motives among adolescents and emerging adults using a predetermined set of motives, largely adapted from the alcohol literature. This research was designed to identify marijuana motives from the perspective of the user. Recent high school graduates who reported using marijuana (N=634) provided self-generated reasons for using. The most frequently reported reasons included enjoyment/fun, conformity, experimentation, social enhancement, boredom, and relaxation. Regression analyses revealed that experimentation was consistently associated with less use and fewer problems whereas enjoyment, habit, activity enhancement, and altered perception or perspectives were associated with heavier use and more problems.

Social anxiety as a moderator of the relationship between perceived norms and drinking.

OBJECTIVE: College students overestimate the drinking of their peers, and the more they overestimate, the more they drink. The present research was designed to evaluate social anxiety as a moderator of the relationship between perceived norms and drinking among college men and women. METHOD: Participants included 1,217 first-year residence-hall students (62.8% women) who completed Web-based assessments of social anxiety, perceived norms, and self-reported drinking. RESULTS: Results replicated previous research in that students overestimated the drinking of their peers (d = 0.75, p < .001). Students who had higher social anxiety drank somewhat more but did not differ from students who had lower social anxiety on perceived norms. However, the relationship between perceived norms and drinking was stronger among students who had higher social anxiety (d = 0.92, p < .001) relative to less socially anxious students (d = 0.02, p = NS). Higher levels of social anxiety were associated with a stronger relationship between perceived norms and drinking for both men (d = 0.86, p < .001) and women (d = 0.50, p < .001) but stronger for men (d = 0.26, p < .001). CONCLUSIONS: These results corroborate previous literature, which suggests that social factors are important determinants of drinking in this population and suggest that social anxiety is associated with susceptibility to peer influences on drinking. Additional work evaluating whether reductions in social anxiety may ameliorate the impact of perceived norms on drinking would be worthwhile.

Harm reduction and individually focused alcohol prevention.

This paper provides a brief overview of harm reduction and individually focused alcohol prevention strategies. Universal, selective, and indicated prevention strategies are described for several populations including elementary and secondary schools, colleges, and medical settings. This paper primarily reviews individually focused alcohol prevention efforts in the United States (US), where harm reduction has been less well received in comparison to many European countries, Canada, and Australia. Zero-tolerance approaches continue to be the norm in individually focused prevention efforts in the US, especially amongst adolescents, despite research suggesting that harm reduction approaches can be effective. Moreover, existing evidence supports that harm reduction approaches show considerable promise in universal prevention and have become best practices in selective and indicated prevention contexts.