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Syndemic theory seeks to understand the interactions and clustering of disease and social conditions and explain racial disparities in HIV. Traditionally applied to HIV risk, this study characterizes the syndemic challenges of engagement in care among Black men living with HIV and provides insight into potential HIV treatment interventions to retain vulnerable individuals in care. Interviews were conducted with 23 HIV-positive men who were either out-of-care or nonadherent to antiretroviral therapy (ART). Interviews were audio recorded, transcribed verbatim, and coded using MAXQDA qualitative software. Researchers analyzed data using thematic content analysis to identify syndemic factors associated with disengagement in care or suboptimal ART adherence among Black men. Analyses revealed the syndemic nature of four themes: intersectional stigma, depression, substance use, and poverty. Findings from this study offer numerous opportunities for intervention including social and structural-level interventions to address syndemic processes and the influence of stigma and poverty on engagement in care.

Among adults living with HIV, unstable housing is a barrier to health. Stably- and unstably-housed adults living with HIV were assessed for over 25 months. At baseline, unstably-housed adults living with HIV had a more recent HIV diagnosis, higher viral loads, worse physical and mental health, lower rates of antiretroviral therapy use and insurance coverage, and higher rates of hard drug use than stably-housed adults living with HIV. At follow-up, the health of both groups was similar, but unstably-housed adults living with HIV reported significantly more hard drug use and mental health symptoms when compared to the stably-housed adults living with HIV. Drug and mental health risks decreased for both groups, but decreases in unprotected sex were greater among unstably-housed adults living with HIV.

Mistrust of science has seeped into public perception of the most fundamental aspect of conservation— extinction. The term ought to be straightforward, and yet, there is a disconnect between scientific discussion and public views. This is not a mere semantic issue, rather one of communication. Within a population dynamics context, we say that a species went locally extinct, later to document its return. Conveying our findings matters, for when we use local extinction, an essentially nonsensical phrase, rather than extirpation, which is what is meant, then we contribute to, if not create outright, a problem for public understanding of conservation, particularly as local extinction is often shortened to extinction in media sources. The public that receives the message of our research void of context and modifiers comes away with the idea that extinction is not forever or, worse for conservation as a whole, that an extinction crisis has been invented.

Seriously mentally ill women at risk for HIV infection ( n = 96) participated in structured interviews assessing sexual and substance-use behavior over a 3-month period. The majority of the women (63.5%) did not use condoms. Consistent with the theory of reasoned action, attitudes toward condom use and perceived social norms about safer sex were associated with safer sex intentions. Supplementing variables from the theory of reasoned action with safer sex self-efficacy explained additional variance in safer sex intentions. Greater safer sex intentions were related to both greater condom use and less frequent unprotected intercourse. In addition, less frequent sex after drug use and a less fatalistic outlook were associated with less frequent unprotected intercourse. Life circumstances specific to this population are particularly important to examine to improve the effectiveness of risk reduction interventions for seriously mentally ill women.

HIV seroconversions and sexually transmitted diseases (STDs) are often clustered in social networks within community populations. The present study was carried out among men who have sex with men in Russia, where a major HIV epidemic is unfolding, and where social networks have played a historically important role. In all, 38 social networks were recruited into the study, and members of all networks ( n = 187) completed risk behaviour assessments and were tested for STDs. About 17% of participants had STDs, and 10% of men had syphilis. Over 64% of men had recent unprotected anal intercourse (UAI), including 51% who did so with main partners, 30% who did so with casual partners, and 32% who had UAI with multiple male partners. The strongest predictor of all risk behaviour indicators and STDs was the social network, to which an individual belonged, supplemented by peer norm perceptions and intentions to practise safer sex. There was a high level of correspondence in behaviour between the social leader of a network and its other members. Social networks should be directly targeted in HIV prevention efforts.

The purpose of this descriptive study was to compare young Russian NEP attenders (N = 209) and nonattenders (N = 207) on a multitude of dependent variables related to drug and sexual knowledge, attitudes, and behaviors. Questionnaire data found NEP attenders were more likely to be female, inject more frequently, use heroin heavily, be in long-term relationships, use clean needles, have more unprotected vaginal sex acts, and have drug-using friends with positive safer sex attitudes. Comparisons were also made between male and female NEP attenders, male NEP attenders and nonattenders, female NEP attenders and nonattenders, and male and female NEP nonattenders. Significant differences between those subgroups were found. A logistic regression was run to determine which variables served to predict NEP attendance. Four variables accounted for 17% of the variance and predicted NEP attendance in two thirds of the cases: safer sex attitudes of drug-using friends, heroin use, using new needles to inject, and relationship status.

HIV/AIDS has emerged as a grave public health threat in Central and Eastern Europe and in the Central Asian republics over the past five years. Massive political, social, cultural, and behavioural changes - along with economic upheaval and collapse of the public health infrastructure in many countries - have created circumstances conducive to the rapid spread of HIV. This paper reviews HIV and sexually transmitted disease (STD) data for all countries in the region, as well as behavioural, social, cultural, and other HIV epidemic enabling factors. The epidemiological picture of HIV in the region is mixed. Russia, Ukraine, Moldova and Belarus already have advanced epidemics. Some other countries in the region share similar enabling factors and have seen a very high proportion of their total number of HIV infections detected in only the past 18 months, indicating the emergence of recent epidemics. Several countries are more stable in their HIV incidence. Behavioural studies indicate that risky sexual and injection related practices are common in many vulnerable populations. HIV prevention steps, if taken quickly enough and on a large scale, can limit the scope of the HIV epidemic that is now unfolding in Central and Eastern Europe. This will require new models of government/non-governmental organization cooperation, policy approaches for addressing structural factors underlying the epidemic, and attention to human rights protection.

Studies on HIV and STD risk factors among vulnerable minority groups in Eastern Europe are underrepresented in the literature. The rapid increase in HIV and STD rates observed throughout the region may quickly affect impoverished, stigmatized, and underprivileged communities. Roma (or Gypsies) constitute such a vulnerable group. A total of 324 men aged 14-37 years were recruited during June-July 2001 in a Roma community neighbourhood in Sofia, Bulgaria. HIV/STD risk behaviours were widespread. Men reported a mean of 2.4 female partners in the past 3 months and 77% did not use a condom during their most recent vaginal intercourse. 72% of Roma men said they had engaged in anal intercourse with women in the past 3 months and almost 75% of these heterosexual anal intercourse occurrences were unprotected. 27% reported having sex with other men during their lifetimes, 10% had same-sex anal intercourse partners in the past 3 months, and 58% of the most recent anal intercourse acts by these men were not condom-protected. 16% of men reported selling sex, and 32% paid someone for sex. Positive condom-use attitudes, intentions, norms and self-efficacy, as well as younger age and condom availability, were factors associated with lower sexual risk. These factors should be targeted in rapid, comprehensive, and culturally sensitive prevention interventions for Roma communities.

In this paper, we report on the results of what we believe to be the first population-based, random-digit telephone AIDS survey conducted in Russia. Recent and rapidly increasing STD and HIV rates show the extremely urgent need for HIV prevention programmes in Russia. HIV sexual risk behaviour, knowledge, attitudes, and personal concern characteristics were assessed in a sample of men and women aged 15–55 years living in 435 St Petersburg households. Many factors related to high HIV risk were found in this study. Only 6% of respondents reported consistent condom use, and 78% reported that they never or seldom used condoms. At the same time, over 13% had 3 and more sexual partners during the last year and 12% had 10 and more lifetime partners. Occasional or frequent anal sex was reported by 13% of those surveyed. Two-thirds of respondents acknowledged personal risk for getting HIV but fewer than 25% indicated that they had taken steps to reduce the risks. One-third of respondents believed that condoms are not an effective protection against HIV. Forty-eight per cent of respondents believed that HIV could be transmitted through kissing, 56% through mosquito bites, and 29.2% through sharing cigarettes. HIV/AIDS prevention efforts for the general public and also targeted campaigns directed toward high-risk communities must be quickly undertaken in Russia.

In the past, HIV disease meant an almost invariably downward health course. New highly active antiretroviral therapy (HAART) regimens have improved the health outlook for many persons living with HIV/AIDS but may create new psychological and coping challenges. In this study, open-ended, in-depth interviews were undertaken with an ethnically diverse sample of 44 purposively selected men and women with HIV disease who were on HAART regimens. The interviews were transcribed and qualitatively coded to identify major themes. While patients responding well to the regimens held optimistic views for their future, some who continued to have detectable viral load exhibited depression and feelings of hopelessness. Many patients reported stress associated with the demands of adhering to complex HAART regimens. Other common themes emerging in the interviews involved concerns about employment, romantic and non-romantic relationship formation, sexual behavior and serostatus disclosure, whether to plan families, and experiences of AIDS-related discrimination. There continue to be critical roles for psychological services in the care of persons living with HIV.

Eastern Europe is experiencing increased rates of HIV/AIDS, and the Russian Federation is among the countries with the most alarming case rate increases. Behavioural and biological studies demonstrate that the transmission of HIV in Russia is occurring as a result of injection drug use, homosexual, and heterosexual risk behaviours. Factors that promote risk and therefore enable HIV transmission in Russia parallel those found in other countries, including epidemics of other sexually transmitted infections, economic instability, poverty, and social factors such as gender roles. Research is urgently needed to better understand and forecast the HIV epidemic in Russia, as well as to develop effective interventions to prevent a Russian AIDS crisis.This article reviews the evidence of an emerging AIDS crisis in Russia and highlights the urgent need for comprehensive HIV prevention efforts in Eastern Europe. It is apparent that there are several HIV epidemics in Russia. Epidemiological data can attest to the multiple modes of HIV transmission in the country, and particularly among young people engaging in heterogeneous patterns of risk behaviors. In addition, HIV genotype research confirms that multiple HIV epidemics are simultaneously emerging in the country. Such research also shows that complicated social forces are advancing HIV sub-epidemics. Enabling factors propagating HIV epidemics include biological and social co-factors, particularly drug use, sexually transmitted diseases, sexual mixing patterns, economic instability, gender roles, and poverty. Wide scale public health education and AIDS awareness campaigns, specialized prevention outreach, social marketing, risk reduction counseling, and prevention policy initiatives directed toward communities and population segments at highest risk for infection are recommended to help curb the HIV epidemic.

Investigates the perceptions and responses of members of five diverse religious congregations to the spiritual needs of people living with AIDS, the impact of AIDS on membership participation, and the beliefs held by different congregations regarding AIDS. Evaluates and compares the AIDS-related perceptions of 204 participants in five congregations (Buddhists, Catholic, Fundamental Christians, Protestants, and Unitarians). Results indicated that congregations differed in how their members responded to the spiritual needs of people living with HIV/AIDS, the level of influence AIDS had on membership participation in formal religions, and whether AIDS was seen as the result of sinful behavior or divine retribution. Concludes that the congregational differences appeared consistent with the core beliefs of the faith communities. Suggests that clergy and congregations need to take specific steps to provide spiritual support to people living with HIV/AIDS consistent with their history of caregiving to all people regardless of the crisis situation.

Summary: While a number of studies have examined behavioural and psychosocial correlates of HIV test seeking, most of this research has relied on samples of urban gay men. Less is known about HIV testing rates and factors associated with testing among gay and bisexual men who live in smaller cities. The present research administered surveys to 3969 non-exclusively partnered gay and bisexual men attending gay bars in small American cities to determine (a) rates of HIV test seeking, and (b) how tested and non-tested men differed on a battery of psychosocial indices. A total of 68% of men had been tested for antibodies to HIV-50% in the past year. Men tested for HIV in the past year, compared to men never tested for HIV, knew more people who were HIV positive or were diagnosed with AIDS, had a closer relationship with someone who had died of AIDS, were more likely to be ethnic minorities, reported more conversations with friends about safer sex, and had stronger intentions to use condoms during their next intercourse occasion. Our results indicate that HIV counselling and testing programmes comprise an important component of HIV prevention efforts assisting gay men residing in smaller USA cities.

A completely optical method is described for the simultaneous determination of hemoglobin and myoglobin oxygen saturation. Solution oxygen concentrations were computed from measurements of phosphorescence decay of a soluble palladium porphyrin using the Stern-Volmer quenching relationship. Visible absorption spectra were recorded of hemoglobin/myoglobin mixtures progressively deoxygenated by bacterial aerobic metabolism. Separate hemoglobin and myoglobin oxygenation curves were resolved from the spectra of solutions containing both proteins by curve fitting, with the use of singular value decomposition of the spectra vs. oxygen concentration matrix. The method yielded a P50of 1.2 Torr for horse heart myoglobin at 24 ± 1°C, while the P50for sheep hemoglobin was 23 Torr at the same temperature. These values, obtained from mixtures, compare favorably with literature values determined for hemoglobin and myoglobin separately.

A completely optical method was developed for evaluating myoglobin-oxygen saturation. Solution oxygen concentrations were computed from measurements of phosphorescence decay of a soluble palladium porphyrin according to the Stern-Volmer quenching relationship. Visible absorption spectra were recorded of myoglobin solutions progressively deoxygenated by bacterial aerobic metabolism. Myoglobin oxygenation curves were obtained from the spectra by two full-spectrum procedures, singular value decomposition (SVD) and curve fitting, and by the traditional dual-wavelength isosbestic method. The calculated P50 for horse heart myoglobin at 24 ± 1°C was 1.2 Torr by SVD, 1.2 Torr by curve fitting, and 1.4 Torr by dual-wavelength spectroscopy. These results compare favorably with a value of 1.1 Torr estimated from the work of Rossi-Fanelli and Antonini for human myoglobin. The Hill coefficient, theoretically 1.00 for myoglobin, was experimentally determined to be 0.96 by SVD and 0.95 by curve fitting of the spectral data matrix.

The past decade witnessed an alarming increase in prevalence of human immunodeficiency virus (HIV) infection. In this paper, we review the literature on factors which influence the reduction of risk behaviors for human immunodeficiency virus among gay and bisexual men, intravenous drug users, and non-intravenous drug using heterosexual adolescents and adults. In this review, specific attention is paid to the reduction of sexual modes of viral transmission. Several risk reduction factors are identified. Methodological limitations are discussed and suggestions for further research are offered.

The purpose of this study was to obtain black subjects' subjective evaluations of videotapes which depicted assertive and unassertive behavior. Three hundred fifty-four black males and females viewed a professionally developed videotape of a black male or a black female who behaved assertively or passively across four common interpersonal situations. Subjects completed a 26-item interpersonal attraction inventory after viewing a single videotape, thus creating a completely crossed factorial design. Factor analyses and multivariate statistical procedures demonstrated that the black subjects perceived assertive behavior as more competent than passive behavior; however, assertive behavior was perceived as less likeable than passive behavior. Sex differences for the models' behavior and the subjects' sex were minimal. Issues of social validation, interpersonal effectiveness, and the generalization of assertion components across cultures are discussed.

In light of claims that sex roles are differentially related to behavioral flexibility, the current study investigated the relationship between sex role orientations and performance in interpersonal situations. Males and females in each of four sex role categories (masculine-typed, feminine-typed, androgynous and undifferentiated) role-played situations requiring the appropriate expression of either commendatory or refusal assertiveness. Androgynous subjects were most effective in rated skills components for both types of situations, while undifferentiated subjects were highly ineffective. Complex interpersonal situations apparently require the use of well-integrated masculine and feminine social skills.