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This study explored sexual coercion in dating situations among young adults ages 18-25. Focus group discussions were conducted with a mostly street-involved and sexually diverse (straight, gay, lesbian and bisexual) sample of young adults. While aware of the risks of unsafe sex, getting sex whenever possible or getting sex over with outweighed considerations of safer sex and disease transmission. Participants noted that partners could be manipulated or coerced into sex, using alcohol and drugs; obligations, expectations, and guilt; and exploitation of emotional and economic vulnerability. Overall, participants revealed that these factors led to an increase in total number of sexual events and particularly to unsafe sex. While sexual education and safer sex programs often address sexual negotiation, a focus on changing the behaviors of those who coerce partners into sex is also needed to reduce the risk of HIV transmission. [ABSTRACT FROM AUTHOR]

This study explores some of the unique aspects of Aboriginal culture that characterize responses to HIV/AIDS in Canada, specifically high-risk sexual behaviour. Six hundred and fifty eight status Indians were randomly selected from eleven Aboriginal reserves to participate in an AIDS-related health survey. Interview techniques were developed to respond to cultural and community sensitivities. Responses from a subset of 566 individuals who answered all relevant questions were analysed using descriptive statistics and logistic regression to clarify the association between cultural variables and risk-taking. Participation in intercourse was associated with familiarity with Aboriginal traditions, learning about sex from partners and speaking an Aboriginal language. Condom use and the consistency of use were associated with learning about sex from family and through health services. Important challenges exist for the integration of traditional learning methods with knowledge of HIV/AIDS. It is important to understand the conflicting paradigms of Aboriginal tradition, modern medicine and public health service. An awareness of the complexity of culture and differences within and between communities is critical to future research in this area. [ABSTRACT FROM AUTHOR]

This paper reports on the substance use of 612 gay and bisexual men who participated in an HIV risk reduction project. Use/non-use level of substance use, and reported frequency of use prior to sexual activist were examined in relation to number of sexual partners, sexual activities, HIV antibody test seeking behaviour and known HIV status. The use of substances among the study cohort appear to be higher than in a comparable heterosexual male group. An association was found between substance use, and both number of sexual partners and sexual activities. However, no significant difference was found in substance use between men participating in protected versus unprotected anal sex. Similarly, no significant difference was found in the reported frequency of substance use prior to sex by those participating in protected and unprotected anal intercourse. Greater drug use was reported among those who were known to be HIV antibody pisitive. These findings raise issues for further research. The high use of alcohol and drugs by gay and bisexual men may pose significant health risks for this group of men. [ABSTRACT FROM AUTHOR]

Presents the results of a mail survey on alcohol and drug abuse in Ontario. Reasons for the survey; Variations in substance abuse; Comparison between surveyed people and the general population in terms of substance use.

To re-examine the relationship between alcohol consumption and violent crime, 100 men from a Scottish prison were interviewed. Fifty respondents (the assailants) were convicted of violent offences and 50 (the control group) had been convicted of non-violent offences. Assailants were more likely to have consumed alcohol at the time of the offence than the controls. The discrepancies which were found support previous findings that alcohol consumption at the time of the offence is associated with violent crime. The relationship cannot, however, be explained simply by the 'intoxicating effect' of alcohol. A pattern of regular heavy drinking was evident amongst both sub-groups. [ABSTRACT FROM AUTHOR]

Background Objective Method Results Conclusion Stealth assessment is a learning analytics method, which leverages the collection and analysis of learners' interaction data to make real‐time inferences about their learning. Employed in digital learning environments, stealth assessment helps researchers, educators, and teachers evaluate learners' competencies and customize the learning experience to their specific needs. This adaptability is closely intertwined with theories related to learning, engagement, and motivation. The foundation of stealth assessment rests on evidence‐cantered design (ECD), consisting of four core models: the Competency Model (CM), Evidence Model, Task Model, and Assembly Model.The first step in designing a stealth assessment entails producing operational definitions of the constructs to be assessed. The CM establishes a framework of latent variables representing the target constructs, as well as their interrelations. When developing the CM, assessment designers must produce clear descriptions of the claims associated with the latent variables and their states, as well as sketch out how the competencies can be measured using assessment tasks. As the designers elaborate on the assessment model, the CM definitions need to be revisited to make sure they work with the scope and constraints of the assessment. Although this is the first step, problems at this stage may result in an assessment that does not meet the intended purpose. The objective of this paper is to elucidate the necessary steps for CM development and to highlight potential challenges in the process, along with strategies for addressing them, particularly for designers without much formal assessment experience.This paper is a methodological exposition, showcasing five examples of CM development. Specifically, we conducted a qualitative retrospective analysis of the CM development procedure, wherein participants unfamiliar with ECD applied the framework and showcased their work. In a stealth assessment course, four groups of students (novice stealth assessment designers) engaged in developing stealth assessments for challenging‐to‐measure constructs across four distinct projects. During their CM development process, we observed various activities to pinpoint areas of difficulty.This paper presents five illustrative examples, including one for assessing physics understanding and four for the development of CMs for four complex competencies: (1) systems thinking, (2) online information credibility evaluation, (3) computational thinking, and (4) collaborative creativity. Each example represents a case in CM development, offering valuable insights.The paper concludes by discussing several guidelines derived from the examples discussed. Emphasizing the importance of dedicating ample time to fine‐tune CMs can significantly enhance the accuracy of assessments related to learners' knowledge and skills. It underscores the significance of qualitative phases in crafting comprehensive stealth assessments, such as CMs, alongside the quantitative statistical modeling and technical aspects of these assessments. [ABSTRACT FROM AUTHOR]

The purpose of this study is to develop a nonparametric DIF method that (a) compares focal groups directly to the composite group that will be used to develop the reported test score scale, and (b) allows practitioners to explore for DIF related to focal groups stemming from multicategorical variables that constitute a small proportion of the overall testing population. We propose the nonparametric root expected proportion squared difference (REPSD) index that evaluates the statistical significance of composite group DIF for relatively small focal groups stemming from multicategorical focal variables, with decisions of statistical significance based on quasi‐exact p values obtained from Monte Carlo permutations of the DIF statistic under the null distribution. We conduct a simulation to evaluate conditions under which the index produces acceptable Type I error and power rates, as well as an application to a school district assessment. Practitioners can calculate the REPSD index in a freely available package we created in the R environment. [ABSTRACT FROM AUTHOR]

The original version of this article unfortunately contained a mistake. In the section, “Data Collection Procedure”, the last sentence was incorrect. [ABSTRACT FROM AUTHOR]

Background: With the recent shift in focus to addressing HIV risk within relationships and couple-based interventions to prevent HIV transmission, successful recruitment of individuals involved in HIV-serodiscordant relationships is crucial. This paper evaluates methods used by the Positive Plus One (PP1) study to recruit and collect data on a diverse national sample of dyads and individuals involved in current or past HIV-serodiscordant relationships, discusses the strengths and limitations of the recruitment approach, and makes recommendations to inform the interpretation of study results and the design of future studies.Methods: PP1 used a multi-pronged approach to recruit adults involved in a current or past HIV-serodiscordant relationship in Canada from 2016 to 2018 to complete a survey and an interview. Upon survey completion, index (first recruited) partners were invited to recruit their primary current HIV-serodiscordant partner. We investigated participant enrollment by recruitment source, participant-, relationship-, and dyad-level sociodemographic characteristics, missing data, and correlates of participation for individuals recruited by their partners.Results: We recruited 613 participants (355 HIV-positive; 258 HIV-negative) across 10 Canadian provinces, including 153 complete dyads and 307 individuals who participated alone, and representing 460 HIV-serodiscordant relationships. Among those in current relationships, HIV-positive participants were more likely than HIV-negative participants to learn of the study through an ASO staff member (36% v. 20%, p < 0.001), ASO listserv/newsletter (12% v. 5%, p = 0.007), or physician/staff at a clinic (20% v. 11%, p = 0.006). HIV-negative participants involved in current relationships were more likely than HIV-positive participants to learn of the study through their partner (46% v. 8%, p < 0.001). Seventy-eight percent of index participants invited their primary HIV-serodiscordant partner to participate, and 40% were successful. Successful recruitment of primary partners was associated with longer relationship duration, higher relationship satisfaction, and a virally suppressed HIV-positive partner.Conclusions: Our findings provide important new information on and support the use of a multi-pronged approach to recruit HIV-positive and HIV-negative individuals involved in HIV-serodiscordant relationships in Canada. More creative strategies are needed to help index partners recruit their partner in relationships with lower satisfaction and shorter duration and further minimize the risk of "happy couple" bias. [ABSTRACT FROM AUTHOR]

Sexual minority men report higher psychological distress than heterosexual men, including depression and anxiety. Research suggests that these health disparities may be due to the heightened stressors that gay, lesbian, and bisexual individuals experience. Some of these stressors occur early on in life, such as childhood abuse and bullying, and may include stressors that are topically related to sexual minority status, such as anti-gay bullying and teasing for gender nonconformity to masculine gender norms. We tested a structural equation model on the association between negative childhood experiences and adult psychological distress among 304 gay and bisexual men. The model fit the data well, and demonstrated an indirect effect of negative childhood experiences on adult psychological distress via dysfunctional thoughts toward oneself. The results integrate the childhood abuse and anti-gay bullying victimization literatures by showing that both forms of adverse childhood experiences are associated with adult psychological distress. The findings suggest the benefit of treatments to reduce negative, dysfunctional thoughts among gay and bisexual men who have experienced adverse childhood events. [ABSTRACT FROM AUTHOR]

In this paper, we extend Michel Foucault's final works on the 'care of the self' to an empirical examination of research practice in community-based research (CBR). We use Foucault's 'morality of behaviors' to analyze interview data from a national sample of Canadian CBR practitioners working with communities affected by HIV. Despite claims in the literature that ethics review is overly burdensome for non-traditional forms of research, our findings suggest that many researchers using CBR have an ambivalent but ultimately productive relationship with institutional research ethics review requirements. They understand and use prescribed codes, but adapt them in practice to account for the needs of participating community members, members of their research teams and the larger communities with whom they work. Complying with ethics protocols was seen as only the beginning, a minimum standard; our research suggests that the real ethical work happens in the field, where CBR practitioners encounter community members in diverse public roles and must forge ethical consensus across communities. CBR represents an ethical terrain in which practitioners challenge themselves to work differently, and as a result they care for themselves-and others-in ways that often resist the propensity for domination through public health research. [ABSTRACT FROM AUTHOR]

Sexual assault is a pervasive, violent and often gendered crime that can result in significant negative consequences. Many sexual assault survivors consider disclosing to health and social care providers, therapists, and others who collectively fall under the banner of formal support, in order to access information, referrals, treatment and/or emotional support, however barriers to disclosure remain. This qualitative study is unique in its application of an intersectional sexual assault stigmatization framework to understand (non)disclosure to formal support providers among diverse sexual assault survivors. Through anonymous online narratives posted to the platform Reddit, survivors documented experiences of intersectional sexual assault stigma (perceived, internalized, anticipated, experienced) showing that they were not only stigmatized through negative gender stereotyping, but they were also marginalized through other structural inequities. The experience of multiple marginalization that arose from intersectional sexual assault stigma often impeded survivors in accessing and/or utilizing the formal support they wished for. The findings suggest that formal support providers could benefit from stigma reduction training related specifically to sexual assault survivors and that current models of stigma and discrimination training need to be expanded to include intersectional stigma. Further, the findings suggest that beyond training at an organizational level, a broader intervention aimed at reducing structural stigma and discrimination toward sexual assault survivors at a societal level appears warranted. Implications for future research related to the unique disclosure, health, and social care needs of diverse sexual assault survivors and support-seeking online alongside or in lieu of formal support are discussed. • Anonymous posts by survivors of sexual assault to the platform Reddit were analyzed. • Survivor's posts revealed experiences of stigma related to the sexual assault. • Sexual assault stigma intersected with other (underexplored) stigmatized attributes. • Intersectional sexual assault stigma hindered disclosure to formal support providers. • Formal support providers should recognize and respond to intersectional stigma. [ABSTRACT FROM AUTHOR]

Gay and bisexual men (GBM) continue to have a disproportionately higher HIV incidence than any other group in Canada and the United States. This study examined how multiple co-occurring psychosocial problems, also known as a syndemic, contribute to high-risk sexual behavior among GBM. It also examined the impact of early life adversity on high-risk sexual behavior as mediated by syndemic severity. A sample of 239 GBM completed self-report questionnaires at baseline and 6-month follow-up. Syndemic variables included depression, polysubstance use, and intimate partner violence. Early life adversity variables measured retrospectively included physical and verbal bullying by peers and physical and sexual abuse by adults. A Cochran-Armitage trend test revealed a proportionate increase between number of syndemic problems and engagement in high-risk sex ( p < .0001), thereby supporting syndemic theory. All early life adversity variables were positively correlated with number of syndemic problems. A bootstrap mediation analysis revealed indirect effects of two types of early life adversity on high-risk sex via syndemic severity: verbal bullying by peers and physical abuse by adults. There was also an overall effect of physical bullying by peers on high-risk sexual behavior, but no specific direct or indirect effects were observed. Consistent with syndemic theory, results provide evidence that certain types of early life adversity impact high-risk sex later in life via syndemic problems. Behavioral interventions to reduce sexual risk among GBM should address anti-gay discrimination experienced before adulthood as well as adult psychological problems. [ABSTRACT FROM AUTHOR]

The “general public” and specific “communities” are increasingly being integrated into scientific decision-making. This shift emphasizes “scientific citizenship” and collaboration between interdisciplinary scientists, lay people, and multi-sector stakeholders (universities, healthcare, and government). The objective of this paper is to problematize these developments through a theoretically informed reading of empirical data that describes the consequences of bringing together actors in the Canadian HIV community-based research (CBR) movement. Drawing on Foucauldian “governmentality” the complex inner workings of the impetus to conduct collaborative research are explored. The analysis offered surfaces the ways in which a formalized approach to CBR, as promoted through state funding mechanisms, determines the structure and limits of engagement while simultaneously reinforcing the need for finer grained knowledge about marginalized communities. Here, discourses about risk merge with notions of “scientific citizenship” to implicate both researchers and communities in a process of governance. [ABSTRACT FROM AUTHOR]

Syndemics research shows the additive effect of psychosocial problems on high-risk sexual behavior among gay and bisexual men (GBM). Psychosocial strengths may predict less engagement in high-risk sexual behavior. In a study of 470 ethnically diverse HIV-negative GBM, regression models were computed using number of syndemic psychosocial problems, number of psychosocial strengths, and serodiscordant condomless anal sex (CAS). The number of syndemic psychosocial problems correlated with serodiscordant CAS (RR = 1.51, 95% CI 1.18-1.92; p = 0.001). When adding the number of psychosocial strengths to the model, the effect of syndemic psychosocial problems became non-significant, but the number of strengths-based factors remained significant (RR = 0.67, 95% CI 0.53-0.86; p = 0.002). Psychosocial strengths may operate additively in the same way as syndemic psychosocial problems, but in the opposite direction. Consistent with theories of resilience, psychosocial strengths may be an important set of variables predicting sexual risk behavior that is largely missing from the current HIV behavioral literature.

Indigenous peoples living with HIV are less likely than non-Indigenous peoples living with HIV to access antiretroviral therapy; however, there is not enough contextual information surrounding this issue. The Indigenous Red Ribbon Storytelling Study was conducted in part to examine how Indigenous peoples living with HIV construct and understand their experiences accessing antiretroviral therapy. Our study design was critical Indigenous qualitative research, using the Behavioral Model of Health Services Use and community-based participatory research approaches. The study was conducted in partnership with Indigenous and non-Indigenous organizations. Study participants were adults from two Canadian cities. The study methods included 20 individual and two Indigenous sharing circle interviews, six participant observation sessions, a short survey and thematic analysis. Accessing antiretroviral therapy within the context of living with a substance use disorder was an overarching theme. Indigenous peoples living with HIV felt they had to choose between living with their active substance use disorder and accessing antiretroviral therapy. They felt misunderstood as a person living with a substance use disorder and often felt coerced into using antiretroviral therapy. Despite these challenges, they persevered as Indigenous peoples living with HIV and a substance use disorder. Further research on antiretroviral therapy access among Indigenous peoples living with HIV and a substance use disorder, particularly from the perspective of health service providers, is needed.

This study assessed the level of internalized homophobia and associated factors among men who have sex with men (MSM) in Nigeria. Using respondent driven sampling, MSM were recruited in Lagos and Ibadan between July and September, 2006. Internalized homophobia was assessed as a negative composite score using an 11-item scale. A total of 1,125 MSM were interviewed. About 44.4% self-identified as homosexual or gay while 55% regarded themselves as bisexual. About a third of the respondents reported internalized homophobia. With homosexual/gay men as reference, respondents who self-identified as bisexual were two times more likely [AOR 2.1; 95 CI: 1.6 - 2.9, p < 0.001] to report internalized homophobia. Those who were HIV positive were also twice as likely to report internalized homophobia compared to those who were HIV negative [AOR 1.8; 95% CI: 1.2 - 2.7, p = 0.004]. As internalized homophobia impedes acceptance of HIV prevention programming, identifying MSM who experience internalized homophobia is integral to the success of HIV prevention programming in Nigeria.