Exclusively breastfed infants in developing countries are at lower risk of HIV transmission than mixed-fed infants. Ethno-graphic research was conducted in eleven low-resource settings across South Africa, Namibia and Swaziland to understand how the perceptions and experiences of counselling health workers, pregnant women and recent mothers could be used to improve infant feeding counselling. Despite prevention of mother-to-child transmission (PMTCT) programmes, very early mixed-feeding remains the norm; traditional conceptualisations of 'water as life' and 'milk as a fluid' are holding up against current PMTCT education, with milk considered liquid 'drink' rather than 'real food'. This aggravates an 'insufficient milk syndrome' where disempowered mothers perceive their breastmilk, and themselves, as deficient - 'not good enough'. Infant feeding is embedded within traditional relationships of intimacy; both relatives and breadwinner have influence and even authority over options and modes of infant feeding. In patriarchal and violent societies, traditional power differentials prohibit easy or complete HIV disclosure or condom negotiation; HIV status remains hidden from most partners and relatives. This context of secrecy means that the traditional advice and authority, which the mothers feel they dare not disregard, is often blind to the mother and her infant's HIV status and survival needs.
Background: There has been widespread concern that the COVID-19 pandemic may be a high-risk time for alcohol use among heavy drinking populations such as college students. Initial efforts to evaluate changes in college drinking have not yet accounted for typical drinking patterns within a semester.Methods: To fill this gap, we evaluated how college student drinking patterns changed with the onset of restrictions related to the COVID-19 pandemic during spring 2020 relative to spring 2018 and 2019. Participants were 1,365 college students aged 19 and older, including 895 students who reported pastmonth alcohol use. Daily drinking data were extracted from an online Timeline Followback survey.Results: Negative binomial hurdle models revealed that, with the onset of the COVID-19 pandemic in spring 2020, college student drinkers did not increase their drinking frequency as was typical in late spring semester, and the number of drinks per occasion declined substantially (28% reduction), greater than the change observed from early to late spring 2018 (3% reduction) or spring 2019 (8% increase). This reduction in drinking quantity in spring 2020 was larger for college student drinkers who moved residences because of the pandemic (49% reduction) than students who did not move (21% reduction). Perceptions in pandemic-related changes in drinking also revealed that 83.5% of college student drinkers self-reported that their drinking stayed the same or decreased.Conclusions: Findings suggest that, on average, college students drank less-not more-during the onset of the COVID-19 pandemic and highlight the importance of living situation in college student drinking behavior. More research is needed to assess alcohol use in other universities, as this information could be utilized in norms-based interventions to further reduce drinking in students who remain at risk.
Objective: Sexual assault is associated with higher rates of posttraumatic stress disorder (PTSD) than other traumas, and the course of PTSD may differ by trauma type. However, the course of PTSD after sexual assault has not been summarized. The aim of this meta-analysis was to identify the prevalence and severity of PTSD and changes to the average rate of recovery in the 12 months following sexual assault. Method: Authors searched four databases for prospective studies published before April 2020 and sought relevant unpublished data. Eligible studies assessed PTSD in at least 10 survivors of sexual assault in at least two time points, starting within 3 months postassault. Random effects linear-linear piecewise models were used to identify changes in average recovery rate and produce model-implied estimates of monthly point prevalence and mean symptom severity. Results: Meta-analysis of 22 unique samples ( N = 2,106) indicated that 74.58% (95% confidence interval [CI]: [67.21, 81.29]) and 41.49% (95% CI: [32.36, 50.92]) of individuals met diagnostic criteria for PTSD at the first and 12th month following sexual assault, respectively. PTSD symptom severity was 47.94% (95% CI: [41.27, 54.61]) and 29.91% (95% CI: [23.10, 36.73]) of scales’ maximum severity at the first and 12th month following sexual assault, respectively. Most symptom recovery occurred within the first 3 months following sexual assault, after which point the average rate of recovery slowed. Conclusions: Findings indicate that PTSD is common and severe following sexual assault, and the first 3 months postassault may be a critical period for natural recovery.
Objective: This study outlines the construction and initial psychometric properties of the Coronavirus Impact Scale in multiple large and diverse samples of families with children and adolescents. The scale was established to capture the impact of the coronavirus pandemic. Differences in impact between samples and internal structure within samples were assessed.Method: Five hundred, seventy-two caregivers of children and adolescents or expecting mothers in diverse clinical and research settings completed the Coronavirus Impact Scale. Samples differed in developmental stage, background, inpatient/outpatient status, and primary research or clinical setting. Model free methods were used to measure the scale’s internal structure and determine a scoring method. Differences between samples in specific item responses were measured by multivariate ordinal regression.Results: The Coronavirus Impact Scale demonstrated good internal consistency in a variety of clinical and research populations. Single, immigrant, predominantly Latinx mothers of young children reported the greatest impact across groups, with elevated impact on food access and finances. Individuals receiving outpatient or inpatient care reported greater impacts on health care access. Impact was positively associated with measures of caregiver anxiety and both caregiver- and child-reported stress at a moderate effect size.Conclusion: The Coronavirus Impact Scale is a publicly available scale with adequate psychometric properties for use in measuring the impact of the coronavirus pandemic in diverse populations.
With widespread concern for increased alcohol use during the COVID-19 pandemic, there is a pressing need to examine changes in young adults’ alcohol use and to identify antecedents of increased use. We tested the hypothesis that self-reported changes in alcohol use during the pandemic (frequency, quantity, heavy episodic drinking) would relate to perceptions of peers’ changes in alcohol use. In April of 2020, 507 college students self-reported changes in their alcohol use and perceived changes in use for typical students at their university (i.e., norms). Most students in our sample reported decreased alcohol use and perceived decreases in peers’ alcohol use. Perceptions of peers’ changes in alcohol use behavior strongly related to changes in students’ own alcohol use. Findings provide strong support for norms-based strategies that can correct normative misperceptions by highlighting the fact that most college students are not in fact engaging in heavier alcohol use during the COVID-19 pandemic.
One victimization experience can increase the risk for subsequent victimization, which is known as revictimization. The aims of this study were to build on sexual revictimization research by (a) broadening the understanding of revictimization to interpersonal (and potentially noninterpersonal) trauma generally and (b) gaining specificity in the mechanisms that underlie revictimization. Using a prospective multisite design, an ethnically and racially diverse sample of 453 young women from the community (age range: 18–25 years, 60.7% European American) completed an initial survey and at least one follow‐up survey within the subsequent year. Participants completed self‐report measures of trauma history, posttraumatic stress symptoms, and maladaptive posttraumatic cognitions. Structural equation models revealed that interpersonal revictimization was observed when controlling for past noninterpersonal trauma, odds ratio (OR) = 2.27, 95% CI [1.23, 4.18], and supported the role of posttraumatic stress symptoms as a mechanism underlying such revictimization, 95% CI of indirect effect (IE) [0.08, 0.51]. Additionally, a history of noninterpersonal trauma (controlling for past interpersonal trauma) increased risk of subsequent interpersonal victimization via posttraumatic stress symptoms, 95% CI of IE [0.01, 0.38]. Notably, however, when maladaptive cognitions were included as mediators in addition to posttraumatic stress symptoms, the only unique indirect effect was for the association between interpersonal trauma and risk of revictimization specifically through perceived threat of harm, 95% CI of IE [0.05, 0.20]. These findings suggest that efforts to reduce interpersonal revictimization should target maladaptive posttraumatic cognitions, particularly perceptions of threat in the environment.
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