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This article articulates a contextualized understanding of gender and ethnicity as interacting social determinants of HIV risk and acquisition, with special focus on African Americans and Hispanics/Latinos--2 ethnic groups currently at most risk for HIV/AIDS acquisition in the United States. First, sex and gender are defined. Second, a conceptual model of gender, ethnicity, and HIV risk and resilience is presented. Third, a historical backdrop of gender and ethnic disparities is provided, with attention to key moments in history when notions of the intersections between gender, ethnicity, and HIV have taken important shifts. Finally, new frontiers in psychology are presented, with recommendations as to how psychology as a discipline can better incorporate considerations of gender and ethnicity as not only HIV risk factors but also as potential avenues of resilience in ethnic families and communities. Throughout the article, we promulgate the notion of a syndemic intersectional approach, which provides a critical framework for understanding and building the conditions that create and sustain overall community health by locating gendered lived experiences and expectations within the layered conceptual model ranging from the biological self to broader societal structures that define and constrain personal decisions, behaviors, actions, resources, and consequences. For ethnic individuals and populations, health disparities, stress and depression, substance abuse, and violence and trauma are of considerable concern, especially with regard to HIV risk, infection, and treatment. The conceptual model poses new frontiers for psychology in HIV policy, research, interventions, and training. (Contains 1 figure.)

The Women-Centered Program for Women of Color, a culturally congruent sexual health intervention, was implemented in 2018 in Los Angeles County, California, according to the principles of community-based participatory research: enhancing community capacity, establishing sustainable programs, and translating research findings to community settings. Participants exhibited significantly increased knowledge of and interest in preexposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) over time, but no significant change in condom use was evident. Booster sessions are needed to maintain interest in PrEP and PEP given concerns about reproductive and sexual health. (Am J Public Health. 2023;113(S2):S110–S114. https://doi.org/10.2105/AJPH.2023.307296) [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, reports of domestic violence across the United States increased from 21% to 35%. Stay-at-home orders, designed to protect the public against the spread of COVID-19, along with heightened societal stressors as a result of the global pandemic, inadvertently increased rates of illicit drug and alcohol use, job loss, and isolation, resulting in increased stress and nonphysical (e.g., psychological, emotional, economic, technological) abuse that often escalated to physical violence. These processes were exacerbated in marginalized communities. These risks were heightened among Black women and Latinas, who experience high rates of domestic violence, long-standing distrust in law enforcement, and compromised self-reporting or anonymous reporting of abuse. We make recommendations for training key stakeholders (e.g., law enforcement, mental health clinicians, and public health care professionals) to facilitate the safety and well-being of domestic violence survivors and to better manage prevention or intervention efforts targeted at domestic violence. We make public health policy suggestions for individuals, communities, and governing structures. (Am J Public Health. 2023;113(S2):S149–S156. https://doi.org/10.2105/AJPH.2023.307289) [ABSTRACT FROM AUTHOR]

This article describes the nearly half a century career of Dr. Gail E. Wyatt, PhD, and her development of novel methodologies and measures of sexual trauma, specifically the Wyatt Sex History Questionnaire and the University of California, Los Angeles, Life Adversities Screener. These approaches broke the silence around experiences of sexual violence, particularly among African Americans, identifying their effects on sexual functioning and mental health. These novel methods are designed without assuming sexual literacy of respondents, knowledge of anatomy, or that discussing sex is easy or common; they include topics that are considered private and may evoke emotions. Trained professionals administering face-to-face interviews can serve to establish rapport and educate the participant or client while minimizing possible discomfort and shame around the disclosure of sexual practices. In this article, four topics are discussed focusing on African Americans, but they may also be relevant to other racial/ethnic groups: (a) breaking the silence about sex, (b) sexual harassment: its disclosure and effects in the workplace, (c) racial discrimination: identifying its effects as a form of trauma, and (d) the cultural relevance of promoting sexual health. Historical patterns of abuse and trauma can no longer be ignored but need to be better understood by psychologists and used to improve policy and treatment standards. Recommendations for advancing the field using novel methods are provided. [ABSTRACT FROM AUTHOR]

Women with histories of child sexual abuse (CSA) are more likely than those without such experiences to report a variety of negative sexual outcomes. This study examines the explanatory power of a CSA summed composite versus dichotomous (presence/absence) measurement in predicting a comprehensive negative sexual behavior outcome. Study participants were obtained from a community based sample examining women's sexual decision-making. The continuous CSA measurement reflects cumulative histories of CSA through a composite score capturing abuse specific characteristics. Using a cross-validation approach, the sample (n =835) was randomly split and the explanatory power of each measure was examined through a series of multiple linear regressions comparing model fit indexes and performing a formal likelihood ratio test of one model against another. All CSA measures explained a similar percentage of variance but overall the CSA summed composite explained the data significantly better in terms predicting negative sexual experiences and revictimization than a binary measure as demonstrated with the likelihood ratio test. The results were replicated by cross-validating the predictive power of the CSA composite score between the split samples. Consistency of CSA regression estimates for the summed composite between training and validation samples were also confirmed. Given the superiority of the CSA summed composites over the binary variable, we recommend using this measure when examining associations between CSA histories and negative sexual experiences and revictimization. (Contains 4 tables.)

In interviews with 300 Latina women in Los Angeles County, 100 reported experiencing sexual abuse before age 18, and 60 had not disclosed the abuse to anyone. Victims did not differ from other Latina women in demographic characteristics, citizenship status, or level of acculturation. Nondisclosure was related to lower levels of acculturation. Contains 28 references and interview questions. (SV)

This study reports the prevalence of child sexual abuse in 338 African-American and European-American women and compares circumstances to data collected a decade ago. Thirty-four percent reported at least one incident prior to age 18. Ethnic differences were found relating to prevalence and number of incidents. (CR)

Latinas are nearly three times more likely to acquire AIDS than other women in the U.S. Structural equation models were used to test predictor and mediator variables, sex-related outcomes, and behavior. Interview data were used. Acculturation, age, and marriage were associated with risks. Theoretical models and strategies are needed. (Author/EMK)

Examined factors predicting the context of HIV-related sexual behaviors in African American women. Surveys investigated demographics; sexual history, behavior, attitudes, risk, and communication; drug use; contraception; and risk reduction efforts since Magic Johnson's HIV disclosure. Demographics, sexual communication, and past sexual experiences related to increased HIV-related sexual risk-taking. Johnson's disclosure increased protective behaviors. (SM)

I describe 4 protective Strategies that African Americans employ that may challenge current HIV prevention efforts: (1) an adaptive duality that protects identity, (2) personal control influenced by external factors, (3) long-established indirect communication patterns, and (4) a mistrust of 'outsiders.' I propose the Sexual Health Model as a conceptual framework for HIV prevention interventions because it incorporates established adaptive coping strategies into new HIV-related protective skills. The Sexual Health Model promotes interconnectedness, sexual ownership, and body awareness, 3 concepts that represent the context of the African American historical and cultural experience and that enhance rather than contradict future prevention efforts. (Am J Public Health. 2009;99:1941-1945. doi: 10.2105/AJPH.2008.152181)

People of color are disproportionately affected by HIV/ AIDS, yet African American HIV/AIDS researchers are in short supply. Complex historical, structural, sociocultural, and personal barriers can prevent African Americans from becoming well-trained biomedical, behavioral, and social HIV/AIDS researchers. Institutional factors that influence the numbers of African Americans conducting HIV/AIDS research include the limitation of early-career decisions and a lack of exposure to research, research socialization, and mentoring. Two individual-level factors that influence the submission of federally funded research proposals are the limited availability of support for culturally congruent HIV research and African Americans' negative perceptions of their own competence and ability to contribute to society. We discuss progress to ward eliminating disparities experienced by African American HIV/AIDS researchers at the individual, academic institution, and sociopolitical levels. (doi:10.2105/AJPH.2007.131094)

Previous research highlights the need to better understand the complex relationships between factors marginalizing Black men who have sex with men and women (MSMW) living with HIV, including HIV stigma, trauma, and hegemonic masculinity. We examined associations between gender role conflict (GRC), trauma, and HIV stigma in Black MSMW living with HIV. 117 participants completed the UCLA Life Adversities Screener (LADS), measures of GRC, and HIV stigma. A multivariate model with age, gender role, and the LADS as predictors of stigma was statistically significant F (4, 110) = 12.81, p <.0001. The LADS was significantly associated with stigma (b = 11.06, t = 4.17, p <.0001) and moderated by GRC (b = 12.19, t = 2.25, p <.05); stigma increased significantly at high, but not low GRC. High GRC heightens the relationship between trauma and HIV stigma in Black MSMW. Future research must investigate associations among trauma burden, stigma, and GRC among vulnerable populations. [ABSTRACT FROM AUTHOR]

Risky and precautionary sexual behaviors were examined in a community sample of 260 single and married/cohabitating White women. Structural equation modeling was used to assess the ability of age, socioeconomic status (SES), marital status, religiosity, and 9 health belief constructs to predict risky sexual behavior with one's partner, using a barrier method of birth control, unintended pregnancies, and number of sexual partners in the past year. The pattern of results suggests that single White women appear to feel more vulnerable to HIV and STD infection and more likely to engage in risky sexual behavior than do married White women. The discussion focuses on the importance of sociocultural factors in understanding risk behaviors within the social context of relationship status, the complexity of the concept of risk reduction, and the need for going beyond the health belief model in order to develop different HIV prevention strategies for single and married White women.

Objectives. We investigated history of abuse and other HIV-related risk factors in a community sample of 490 HIV-positive and HIV-negative African American, European American, and Latina women. Methods. Baseline interviews were analyzed, and logistic regressions were used to identify predictors of risk for positive HIV serostatus overall and by racial/ethnic group. Results. Race/ethnicity was not an independent predictor of HIV-related risk, and few racial/ethnic differences in risk factors for HIV were seen. Regardless of race/ethnicity, HIV-positive women had more sexual partners, more sexually transmitted diseases, and more severe histories of abuse than did HIV-negative women. Trauma history was a general risk factor for women, irrespective of race/ethnicity. Conclusions. Limited material resources, exposure to violence, and high-risk sexual behaviors were the best predictors of HIV risk.

Predictions generated by cognitive adaptation theory and conservation of resources theory were tested with regard to positive and negative changes associated with HIV infection in an ethnically diverse, low socioeconomic status sample of 189 HIV-positive women. Women reported a significantly greater number of benefits than losses' in their experiences with HIV infection. Changes in the domains of the self and life priorities were significantly positive, whereas changes in romantic/sexual relations and view of body were significantly negative. Women who reported more benefits were less likely to report depressive and anxious symptoms. Although health status and optimism significantly predicted depression, anxiety, and negative HIV-related changes, socioeconomic resources (education and income) were the most significant predictors of HIV-related benefit finding. Implications of these results are discussed.

Almost half the African American women in a research study reported verbal and physical conflict with intimate partners, and most of these had been abused as children. Other factors increasing risk for partner violence include income and HIV status.

Trauma-focused research highlights the reactions of seasoned professionals when engaging with vulnerable clients; however, less is known about the common reactions of novices engaged in trauma research, who may lack the skills to cope and interact with traumatized participants. The purpose of this study is to (a) describe common reactions experienced by novice trauma interviewers; (b) examine whether the issues they face are similar to those of seasoned helping professionals; and (c) discuss ways in which training and supervision can increase the well-being of interviewers in trauma research. A semi-structured assessment was administered to novice interviewers who had previously conducted psychosocial and trauma assessments with diverse community participants. Participation was voluntary. The assessment elicited responses concerning secondary traumatic stress, vicarious trauma, posttraumatic growth, and self-help and resources. Audio files were transcribed; responses were compiled to explore themes and identify illustrative quotes. Eight interviewers (two males, six females) participated. Six reported no prior experience working with populations with histories of trauma. Novice interviewers described experiences of secondary traumatic stress, vicarious trauma, compassion fatigue, posttraumatic growth, and resilience. Novice interviewers described symptoms consistent with those reported by seasoned helping professionals; positive and negative symptoms often coexisted. Interviewers who completed more assessments described reactions of sadness, anger, insomnia, and changes in worldview. Interviewers who shared similar traumatic histories or environments reported more examples of countertransference. All reported similar feelings of posttraumatic growth, such as hope and optimism, for their participants and an increased appreciation of their resilience. Implications for training and supervision are discussed. [ABSTRACT FROM AUTHOR]

A sample of African-American, Latina and White women in LA were surveyed to analyse the links between economic, social and structural factors and HIV-related risk taking. The findings show distinct differences in the ethnic communities influenced by the nature of the family and the economic position of the women. African-American women faced increased risk because of economic instability which led them to sex outside their primary relationships. Latina women in committed relationships faced risk influenced by the sexual history of their partners. The sexual practices of White women increased their risk.

A survey of 248 white and African American women found that white women were more likely to have experienced sexual harassment in the work place. Overall, about half of those surveyed reported some incidence of sexual harassment. African American women reporting harassment tended to be of lower incomes compared to white peers.