This qualitative study examined sociocultural and behavioral factors including sexual health, sexual identity, and sexual risk among HIV-seropositive African American and Latino men who have sex with men (MSM) who also have a history of sexual abuse. Twenty-three men participated in 4 focus groups, responding to conceptually organized questions regarding the relationship between histories of violence and sexual and drug-related HIV risk behaviors for reinfection and transmission. Consensual qualitative research methods were used to analyze audiotaped transcriptions. Seven domains focusing on consensual and nonconsensual sexual practices, cultural and gender-bound beliefs, and social expectations were identified. Implications of these psychosocial issues for HIV-seropositive gay- and non-gay-identifying African American and Latino MSM with histories of sexual abuse in future interventions are discussed.
Background-A large portion of the injuries treated at urban trauma centers are preventable with alcohol and substance use presenting as common antecedent risk factors.
Progression toward autonomy is considered of central importance during the adolescent period. For young adolescents with an HIV-infected parent, there may be additional challenges. This study investigated current autonomy among early and middle adolescents affected by maternal HIV (N = 108), as well as examined longitudinally the children's responsibility taking when they were younger (age 6-11; N = 81) in response to their mother's illness and their current autonomy as early/middle adolescents. In analyses of self-care and family autonomy, children with greater attachment to their mothers had higher autonomy, and there was a trend for children who drink or use drugs alone to have lower autonomy. In analyses of management autonomy, attachment to peers was associated with higher autonomy. Trajectory group findings indicate that those children who had taken on more responsibility for instrumental caretaking roles directly because of their mother's illness showed better autonomy development as early and middle age adolescents. Therefore, 'parentification' of young children with a mother with HIV may not negatively affect later autonomy development.
Many injuries due to interpersonal violence among patients presenting to urban trauma centers for treatment are preventable, with alcohol and illicit drug use presenting as common antecedent risk factors. However, many patients with such problems do not seek treatment. Substance use patients were surveyed to determine how many recognized they had a problem and whether they had previously received treatment for substance use problems. Almost 60% of the patients treated for a facial injury screened for problem alcohol use, and slightly more than 25% screened for problem drug use. Only approximately one-third of patients indicated any movement towards dealing with these problems and of these, only 20% had actually sought treatment. Employment had an effect on treatment seeking, with fewer employed patients seeking help. Utilizing the critical window of opportunity for ED personnel to make referrals may have an impact on treatment seeking for problem level substance use.
Purpose-Assault is the most common cause of facial injuries in adolescents treated at inner-city trauma centers, yet little is known about the behavioral and environmental antecedents of these injuries or the willingness of such at-risk adolescents to participate in behavioral interventions to minimize re-injury. The purpose of this study was to identify possible risk and protective factors among adolescents with assault-related facial injury, and assess their willingness to participate in prospective observational research and behavioral interventions.Patients and Methods-Interviews were conducted with 67 adolescents (range 14 -20 years) who were treated in trauma centers for facial injuries. Most of these injuries were assault-related (59%), followed by motor vehicle or other accidents (29%), gunshot wounds (9%) and sports injuries (3%). The subjects were predominantly male (86%) and ethnic minorities (91%).Results-The adolescents showed high rates of intentional injuries in the past six months (56%), unhealthy alcohol use, and more than half (55%) had problem levels of substance use. As compared to those with unintentional injuries, adolescents who experienced assault-related injuries were more likely to report using alcohol, tobacco and other substances. Although a significant segment of the sample (55%) had been arrested previously, no differences in arrest rates or types of crimes for which
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