Women represent an increasing proportion of AIDS cases and anecdotal reports suggest some face substantial risks when others learn they are HIV-positive. The purpose of this paper is to describe women's fears and experiences regarding disclosure of their HIV status. Fifty HIV-positive women, ages 16-45 from urban teaching hospital outpatient clinics, were interviewed using an in-depth, qualitative interview. Eighty-six percent of the women were African American and 56% were current or former IVDU. At the time of the interview, 88% of the women had known their HIV status for a year or more. All but one woman had disclosed her HIV status to at least one person and 82% had disclosed to multiple people. Although two-thirds of the women had been afraid to disclose to others because of concerns about rejection, discrimination or violence, three-quarters of the sample reported only supportive and understanding responses to their disclosure. One-quarter of the sample reported negative consequences of disclosure, including rejection, abandonment, verbal abuse and physical assault. Disclosure-related violence was discussed by nine women (18%): two who feared violence were relieved to find a supportive response; four chose not to disclose their status because they feared violence; and three women were verbally or physically assaulted. Fear of mistreatment figured prominently in decisions about disclosure among this sample. That many women found supportive and understanding responses is encouraging. However, there were sufficient examples of negative consequences, including violence, to suggest individualized approaches to post-test counseling, enhanced support services for HIV-positive women, and public education to destigmatize HIV-disease.

The likelihood of prevention providers and consumers adopting and implementing evidence-based HIV prevention interventions depends on the strategies employed in translating, packaging, and disseminating the findings from research to practice. Lessons from the Centers for Disease Control and Prevention's Replicating Effective Programs project have shown that to smoothly transfer HIV prevention technology from research to practice, researchers need to prepare for possible transfer during research trials. Preparation should include documenting details of the intervention beyond what is published in journals, including important details regarding what the intervention was about, how preparations for it were made, and how it was delivered. Researchers should also ensure that all relevant stakeholders are integrally involved in all aspects of the research and technology transfer process. Such collaborations encourage exchange of ideas and can make certain that interventions are designed to be relevant and acceptable to community agencies and feasible for them to implement.

Social oppression contributes to YBMSM's psychological vulnerabilities, participation in difficult sexual situations, and their UAI. Interventions to reduce sexual risk in YBMSM should address socioeconomic disadvantage, homophobia, and racism, as well as the psychological challenges that social oppression creates for them.

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Family influences may offer risk and protective effects for adolescent children of maternal drug users. Outreach and family-focused interventions that address family conflict and communication of disapproval of substance use may help reduce intergenerational risk transmission. However, longitudinal research with comprehensive parenting assessments is needed.

In September 2010, CDC launched the Enhanced Comprehensive HIV Prevention Planning (ECHPP) project to shift HIV-related activities to meet goals of the 2010 National HIV/AIDS Strategy (NHAS). Twelve health departments in cities with high AIDS burden participated. These 12 grantees submitted plans detailing jurisdiction-level goals, strategies, and objectives for HIV prevention and care activities. We reviewed plans to identify themes in the planning process and initial implementation. Planning themes included data integration, broad engagement of partners, and resource allocation modeling. Implementation themes included organizational change, building partnerships, enhancing data use, developing protocols and policies, and providing training and technical assistance for new and expanded activities. Pilot programs also allowed grantees to assess the feasibility of large-scale implementation. These findings indicate that health departments in areas hardest hit by HIV are shifting their HIV prevention and care programs to increase local impact. Examples from ECHPP will be of interest to other health departments as they work toward meeting the NHAS goals.

Background Spirituality and religiosity may serve as both a resource and a barrier to HIV prevention with young black men who have sex with men (YBMSM). We examined indices of spirituality/religiosity as correlates of binge drinking, stimulant use, and recent HIV testing in a sample of YBMSM. Methods From 2011–2013, annual venue-based surveys of sexually active YBMSM ages 18–29 were conducted in Dallas and Houston, Texas. Binge drinking and stimulant use were assessed in the past two months. Participants recently tested for HIV (i.e., within the past six months) were compared to those without recent HIV testing (i.e., never tested or tested more than six months ago). Results Among the 1,565 HIV-negative or HIV-unknown YBMSM enrolled, more engagement in spiritual and religious activities was associated with greater odds of reporting stimulant use (Adjusted Odds Ratio [AOR] = 1.20; 95% CI = 1.04 – 1.40) while higher spiritual coping was associated with lower odds of reporting stimulant use (AOR = 0.66; 95% CI = 0.56 – 0.78). Binge drinking was independently associated with 29% lower odds of recent HIV testing (AOR = 0.71; 95% CI = 0.55–0.92), but lower odds of binge drinking did not mediate the association of engagement in spiritual and religious activities with 27% greater odds of recent HIV testing (AOR = 1.27; 95% CI = 1.11–1.46). Conclusions Among YBMSM, culturally tailored approaches addressing spirituality/religiosity could support prevention of stimulant use and increase HIV testing. In particular, expanded efforts are needed to promote HIV testing in binge drinkers.