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The Superwomen Schema (SWS) describes a social framework that encompasses the role that many Black women adopt in response to chronic stress, financial pressures, and an intersection of oppression. Woods-Giscombé (Superwoman Schema: African American Women's Views on Stress, Strength, and Health. Qualitative Health Research 20 (5): 668–683, 2010) characterizes SWS using five tenets: obligation to manifest strength, obligation to suppress emotions, resistance to vulnerability or dependency, determination to succeed despite a lack of resources, and an obligation to help others. The goal of this study is to determine the connection between SWS among Black women and substance use as a means of maintaining mental health, garnering resilience, and coping with external pressures. We aimed to highlight systemic and infrastructural racism and prejudice and how they relate, not only to the adoption of SWS, but also how they may contribute to substance use. This study is a secondary analysis of a larger study on HIV prevention Black and Latine women at high risk for HIV. Only Black participants (n = 10) were included in this secondary analysis. The interviews were conducted 3 times across 3 months. Interviews were coded and analyzed using thematic content analysis in NVivo. Themes of undiagnosed mental health symptoms, medical mistrust, institutional distrust, and aversion to help-seeking were recurrent in our data. Our research confirmed and assessed dual repercussions of SWS among Black women both as a defense that granted resilience in the face of seemingly insurmountable odds and as a construct that encouraged substance use as a coping mechanism for compromised mental health. This study contextualized this subset of coping and substance use to address and dismantle systemic contributors. [ABSTRACT FROM AUTHOR]

Many people enrolled in drug diversion programs are not receiving evidence-based prevention for HIV or hepatitis. This study translated basic research from cognitive science to increase screening for infection and condom use in this population. A parallel three-condition randomized trial was conducted in a drug diversion sample (N = 358), comparing a memory practice condition with two active control conditions. Outcomes were condom use frequency and testing for infection (hepatitis B/C, HIV). At 3-month follow-up, participants in the memory practice condition were at least twice as likely (OR = 2.10 or greater, p <.01) to self-report testing compared to those in the control conditions and also reported more frequent condom use compared to a health education condition [B =.37, t(1) = 2.02, p =.02]. Basic research on memory can be effectively translated to brief interventions on infection screening and risk prevention in existing drug diversion programs. [ABSTRACT FROM AUTHOR]

Background Implementation intentions are situation-linked action plans that increase health behaviors such as condom use. Few studies have measured the strength of implementation intentions, especially regarding condom use. Non-injection drug users are at high risk for HIV due to risky sexual practices. Substance use before sex may increase risky sexual behaviors, and implementation intentions are a promising, practical route for HIV prevention. Purpose This prospective study assessed the measurement properties of the newly developed Strength of Implementation Intentions Scale (SIIS) for condom use and investigated whether the SIIS predicted condom use one-year later. The study evaluated whether behavioral intentions and alcohol or methamphetamine use before sex modified the relationship between the SIIS and condom use. Methods Participants were 590 non-injection drug users convicted of nonviolent drug offenses in court-mandated outpatient drug diversion programs. They completed self-directed computer assessments at baseline and at one-year follow-up. Measures included demographics, behavioral intentions to use condoms, the SIIS for condom use, alcohol and methamphetamine use before or during sex, and condom use. Psychometric properties, direct, and interaction effects of the SIIS were evaluated using structural equation modeling and general linear regressions. Results The SIIS, behavioral intentions, and condom use were positively correlated and there was discriminant validity between all three constructs. In addition, the SIIS predicted condom use one-year later in this high-risk population. No significant interactions were detected. Conclusions The SIIS is predictive of condom use behavior, is psychometrically sound and distinct from behavioral intentions, and can be incorporated into HIV prevention interventions and used as a mediator variable. In addition, it can be used as an outcome measure where a follow-up is not feasible. The SIIS can also be tailored for additional HIV-related behaviors such as HIV-testing, adhering to antiretroviral medication, prescribing and adhering to pre-exposure prophylaxis, and other health behaviors. [ABSTRACT FROM AUTHOR]

Rationale Engaging in risky sexual behavior increases transmission of HIV. Objective The present study used previously elicited salient outcomes of condom use to examine the factor structure and test the predictive utility of a condom use expectancy scale. Methods Participants were drug offenders from court ordered drug diversion programs in Southern California. The condom use expectancy scale consisted of three factors: positive condom outcome items, negative condom outcome items, and safe sex items. Results The factor analysis confirmed the three-factor structure. Positive condom use expectancies were a significant predictor of both condom use and intentions to use condoms, and negative condom use expectancies predicted non-use of condoms. Conclusion Understanding conditions of condom use can aid public health researchers and practitioners to better identify those in need of HIV prevention and how to target those needs. [ABSTRACT FROM AUTHOR]

Background: HIV infection is problematic among all drug users, not only injection drug users. Drug users are at risk for contracting HIV by engaging in risky sexual behaviors. Objective: The present study sought to determine whether inhibitory processes moderate the relationship between problematic drug use and HIV-risk behaviors (unprotected sex and multiple sex partners). Methods: One hundred ninety-six drug offenders enrolled in drug education programs were administered a battery of computer-based assessments. Measures included a cued go/no-go assessment of inhibitory processes, the Drug Abuse Screening Test (DAST) assessment of problematic drug use, and self-report assessment of condom use and multiple sex partners. Results: Findings revealed that response inhibition assessed by the proportion of false alarms on the cued go/no-go moderated the relationship between problematic drug use and an important measure of HIV risk (condom nonuse) among drug offenders. However, response inhibition did not moderate the relationship between problematic drug use and another measure of HIV risk: multiple sex partners. Conclusions: Among this sample of drug offenders, we have found a relationship between problematic drug use and condom nonuse, which is exacerbated by poor control of inhibition. These findings have implications for the development of HIV intervention components among high-risk populations. [ABSTRACT FROM AUTHOR]