These findings provide insight into transgender patients' perceptions of and sensitivity to mistreatment in health care contexts. This information might be used to increase providers' cultural competency and inform their interactions with transgender patients.

Sexting and its potential links to sexual behavior, including risky sexual practices

This manuscript uses the theory of message design logics to investigate the relative sophistication of responses to disclosure of HIV status. In Study 1, 548 college students imagined a sibling revealing an HIV-positive diagnosis. Their responses to the HIV-disclosures were coded as expressive (n = 174), conventional (n = 298), or rhetorical (n = 66). Type of message produced was associated with gender and HIV aversion. In Study 2, 459 individuals living with HIV rated response messages that were taken verbatim from Study 1. Expressive messages were rated lowest in quality, and rhetorical messages were rated highest. The discussion focuses on the utility of message design logics for understanding responses to HIV disclosures and the implications for message design logics. This is the accepted version of the following article: Caughlin, J. P., Brashers, D. E., Ramey, M. E., Kosenko, K. A., Greene, Derlega, Yep, & Petronio, 2003). People often fail to disclose that they are living with HIV because of the stigma associated with the illness and concerns about how others will react (e.g., Alonzo & Reynolds, 1995;Herek, Capitanio, & Widaman, 2002), but keeping the diagnosis a secret can lead to a lack of social support, unsafe sexual behavior, and failure to seek treatment or to take medications as needed (e.g., Chesney & Smith, 1999). Stigma and lack of disclosure of HIV status are such important health concerns that they warrant counseling programs to help these individuals manage the psychological, social, and health aspects of their illness (Rintamaki, Davis, Skripkauskas, Bennett, & Wolf, 2006).Much HIV disclosure research has examined how people living with the disease decide whether to divulge their status (e.g., Derlega, Winstead, & Folk-Barron, 2000;Derlega, Winstead, Greene, Serovich, & Elwood, 2004;Sullivan, 2005). Some research also has examined disclosers' perceptions of the responses they receive when telling others about their HIV-positive diagnosis (Greene & Faulkner, 2002;Serovich, Kimberly, & Greene, 1998). Greene and Faulkner, for example, interviewed 10 female African American adolescents, who described how people responded when told about their HIV diagnosis. The responses varied considerably and included treating the participants unfavorably, having negative emotional reactions, telling others, and providing support.Understanding how people respond to disclosures about HIV-positive status is important for numerous reasons. For instance, people living with HIV often experience uncertainty about how others will react (Brashers et al., 2003). If this uncertainty contributes to anxiety about revealing the information, research describing reactions to HIV disclosures can be useful by illuminating "the issues and dilemmas that may be encountered when disclosing" (Serovich et al., 1998, p. 15). Research on responses to HIV disclosures from the perspective of the responder is also important.People who disclose an HIV-positive test result may hope for various sorts of responses from the recipien...

High HIV prevalence and incidence rates and high-risk sexual activity have been documented in certain subgroups of the transgender community; however, less is known about the sexual experiences and risks shared by these subgroups. To identify contextual features influencing the sexual risk-taking of transgender adults, semi-structured interviews conducted with 41 self-identified transgender adults were analyzed via constant comparative analysis, a technique rooted in grounded theory. Seven aspects of the transgender experience, including stigma, financial hardship, sexual objectification, a lack of outreach, hormones, a second puberty, and gender role issues, created a unique context of risk. Findings indicate that traditional HIV prevention efforts might not be suited to the unique needs of transgender adults. Tailoring HIV prevention efforts to this community will warrant further attention to contextual influences on sexual risk and safety.

People who are HIV-positive must make decisions about disclosing their status to others but do so in the context of stigma and social isolation reported by many with the disease. Disclosing an HIV-positive diagnosis is necessary to seek social support, to manage health care, and to negotiate sexual encounters, but fear of how others will respond is a strong barrier to revealing that information. This investigation focuses on various ways that HIV can be disclosed. Using a multiple-goals perspective, 24 disclosure messages (representing 6 different types) were created. Participants (N = 548) were asked to imagine one of their siblings revealing an HIV-positive diagnosis, using 1 of the 24 messages. Participants' reactions to the disclosures differed substantially across the various message types. The discussion focuses on theoretical explanations for the variations in responses and the utility of these findings for practical interventions concerning HIV disclosures.