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J A Kelly

Publications and source records attributed to J A Kelly.

At least 109 records · Page 6Linked to original sources
PubMed1995

Increased attention to human sexuality can improve HIV-AIDS prevention efforts: key research issues and directions.

Curtailing the human immunodeficiency virus (HIV) epidemic requires the development of effective strategies for helping people reduce high-risk sexual behavior patterns. Because the objective of HIV prevention involves changing how people behave sexually, research findings in human sexuality are extremely pertinent to efforts to promote AIDS risk reduction. Unfortunately, most public health HIV prevention programs rarely reflect findings of human sexuality research. In this article, research is reviewed in the areas of the relationship contexts of sexuality, including variations in monogamy, condom use in affectionate versus casual relationships, sexual communication, and coercion; the modification of sexual behavior repertoires; substance use in relation to sexual intercourse; and sexual schema and scripts relevant to HIV risk. Policy and training issues related to human sexuality may have hindered efforts to incorporate sexuality research findings in HIV prevention programs. Advances and refinements in the success of HIV prevention efforts are likely if research on human sexuality is better integrated in AIDS prevention programs.

Acquired Immunodeficiency Syndrome↗
PubMed1995

HIV antibody testing of gay men in smaller US cities.

The incidence of new AIDS diagnoses among gay males indicates that risk reduction in smaller communities may be lagging behind that reported in larger cities. Contradictory evidence exists, largely from urban areas, concerning the utility of HIV testing as a means of promoting behavioural change. This study examined the relationship between HIV antibody testing and subsequent high-risk sexual behaviours among gay men in cities of 180,000 or fewer inhabitants. In February and March of 1992, male gay bar patrons in sixteen small US cities were administered an anonymous questionnaire concerning recent sexual behaviour and HIV testing history. Of the 1820 respondents, 28.1% had recently engaged in unprotected anal intercourse and 60.7% had been tested for HIV antibodies. Those who had been tested were more sexually active and reported more protected and safer sexual activities. Analyses at the individual and city levels converged to demonstrate that communities as well as individuals evidence increased self-protection in association with HIV antibody testing.

Adult↗
PubMed1995

Group intervention to improve coping with AIDS-related bereavement: model development and an illustrative clinical example.

Despite the widespread losses from AIDS, there have been no published evaluations of mental health interventions for people experiencing AIDS-related bereavement. We describe a cognitive behavioural coping model for support group interventions with people who experience an AIDS-related loss. The support group model consists of six primary components to address grief-related responses and the unique features of AIDS bereavement: social support and group cohesion; identification and expression of emotion; identification of AIDS loss specific coping challenges; recognition of current coping; goal setting; and, implementation of adaptive coping to reduce psychological distress. The model integrates theories of cognitive behavioural coping within a social support group context. Results of a pilot study with four men and four women showed that the intervention model cast into eight group sessions significantly reduced depression, intrusive experiences, grief reactions, demoralization, and overall psychological distress immediately following the intervention and at a 3-month follow-up assessment. The intervention appeared to facilitate the adjustment of these bereaved persons and warrants further study.

Acquired Immunodeficiency Syndrome↗
PubMed1995

The aging semantic differential: a confirmatory factor analysis.

The Aging Semantic Differential (ASD), which is used to measure attitudes and quantify bias and negative stereotypes toward older people, is a 32-item scale published more than 20 years ago (Rosencranz & McNevin, 1969). Several factor analytic studies failed to replicate the original three-factor structure. Confirmatory factor analyses (CFA) using 100 third-year medical students compared six-factor models derived from the gerontological literature. A modified version of Holtzman, Beck, and Kerber's (1979) four-factor model proved to be the "best" comparative fit based upon a consensus of fit indices.

Aged↗
PubMed1995

Use of a brief behavioral skills intervention to prevent HIV infection among chronic mentally ill adults.

OBJECTIVE: Research shows that many chronic psychiatric patients are at risk for infection by the human immunodeficiency virus (HIV). This study investigated the effects of a behavioral skills training program designed to prevent HIV infection among chronic mentally ill adults living in an inner-city area. METHODS: Twenty-seven men and 25 women were randomly assigned either to a four-session AIDS prevention program emphasizing risk education, sexual assertiveness, condom use, risk-related behavioral self-management, and problem-solving skills or to a waiting-list group, who later received the same intervention. RESULTS: Compared with the waiting-list control group, participants in the prevention program demonstrated significant gains in AIDS-related knowledge and intentions to change risk behaviors. The prevention program also significantly reduced rates of unprotected sexual intercourse and increased the use of condoms over a one-month follow-up period. A subset of participants who provided two-month follow-up data maintained some behavior changes. CONCLUSIONS: A relatively brief, skills-focused AIDS prevention program for chronic psychiatric patients produced reductions in HIV risk behaviors. Such HIV risk reduction intervention programs may be of use in inpatient, outpatient, and community-based settings.

Adult↗
PubMed1995

Predictors of high and low levels of HIV risk behavior among adults with chronic mental illness.

OBJECTIVE: Several recent studies confirm elevated rates of human immunodeficiency virus infection among acute and chronic mentally ill adults in large urban areas. This research sought to characterize risk for HIV infection among adults with chronic mental illness and to examine psychosocial factors predictive of risk. METHODS: Two hundred and twenty-five adults with chronic mental illness who were sexually active in the past year outside of exclusive relationships were individually interviewed in community mental health clinics using a structured HIV risk assessment protocol. RESULTS: More than 50 percent of the study participants were sexually active in the past month, and 25 percent had multiple sexual partners during that period. Fifteen percent of the men had male sexual partners. In more than 75 percent of occasions of sexual intercourse, condoms were not used. When participants were categorized as at either high or lower risk for HIV infection based on their pattern of condom use, psychosocial factors that predicted risk level included measures of participants' self-reported efficacy in using condoms, perceptions of social norms related to safer sex among peers and sexual partners, and expectations about outcomes associated with condom use, as well as participants' level of objectively assessed behavioral skills in negotiation and assertiveness in sexual situations. CONCLUSIONS: Interventions aimed at prevention of HIV and AIDS are urgently needed in settings that provide services to persons with chronic mental illness.

Adolescent↗
PubMed1995

Differences in HIV risk characteristics between bisexual and exclusively gay men.

Research investigating HIV-risk sexual behaviors of men who have sex with men usually combines gay and bisexual men, treating them as a single, homogeneous group. However, gay and bisexual men may differ in their HIV risk behavior and in psychological characteristics indicative of risk. Exclusively gay (N = 1,180) and bisexual men (N = 136) completed anonymous surveys at gay bars. The surveys assessed demographic, psychological, and behavioral data related to sexual behavior and HIV risk. Relative to exclusively gay men, bisexual men had lower intentions to use condoms in their next intercourse occasion, reported a greater frequency of oral sex with men and more oral-sex partners, knew fewer people who were HIV positive, and perceived weaker peer norms favoring safer sex and risk avoidance. One-third of bisexual men reported engaging in unprotected anal intercourse, and 17% of bisexual men had multiple unprotected anal sex partners in the past two months. Interventions tailored to the needs of bisexual men are urgently needed and should focus on increasing intentions to use condoms, increasing HIV-risk sensitization, and fostering norms favoring safer sex and risk avoidance.

Adult↗
PubMed1994

Crystallization and preliminary structural studies of neurotrophin-3.

Neurotrophin-3 (NT-3) has been crystallized in 2 forms. Orthorhombic crystals, space group P2(1)2(1)2, diffracted to 2.8 A and have cell dimensions a = 39.1 A, b = 54.0 A, and c = 65.5 A. The second form is space group P4(3)2(1)2, with cell dimensions a = b = 67.1 A, and c = 107.9 A. The tetragonal crystals diffract to 2.8 A at room temperature and 2.5 A at -100 degrees C. The unit cell dimensions change significantly upon freezing, a = b = 66.1 A, and c = 102.8 A. Phases for the orthorhombic form were obtained by molecular replacement using nerve growth factor as the search model. A partially refined model of the NT-3 dimer (75% complete) was then oriented and positioned in the tetragonal cell.

Chemical Phenomena↗
PubMed1994

High risk sexual behavior and alcohol consumption among bar-going gay men.

OBJECTIVES: To determine whether alcohol use prior to sexual behavior influenced the occurrence of unprotected anal intercourse among bar-going gay men. METHODS: Anonymous AIDS behavioral risk surveys were administered to men entering gay bars in 16 cities on three nights in February 1993 in six states in the United States. RESULTS: Of the 1519 men who completed the survey, 85% were current alcohol drinkers. Men who had unprotected anal intercourse after consuming alcohol drank more and reported more incidents of unprotected anal intercourse than men who had unprotected anal intercourse but not after drinking. Overall, unprotected anal intercourse occurred less frequently after alcohol consumption than without prior consumption. CONCLUSIONS: This study found that heavy alcohol use and frequent high-risk sexual behavior occurred among the same individuals. However, we found no evidence for a causal link between alcohol use and unprotected sexual behavior in this sample of bar-going gay men.

Adult↗
PubMed1994

Factors associated with risk for HIV infection among chronic mentally ill adults.

OBJECTIVE: Chronic mentally ill adults have been found to be at risk for HIV infection. The authors investigated the prevalence of HIV risk behaviors among psychiatric outpatients. Correlates of HIV risk factors and characteristics of patient relationships in which risk occurred were investigated. METHOD: Structured interviews were conducted with 95 chronic mentally ill adults from urban community support service programs. The interviews focused on sexual and substance use behavior, history of HIV risk behaviors, and relationship characteristics related to risk. RESULTS: The study showed that 27% of all patients had had two or more sex partners in the previous year and 18% had received money or drugs for sex. High rates of illicit drug use were also found, with frequent use of drugs or alcohol in association with sexual activity. Multiple regression analyses showed that use of illicit drugs, meeting sex partners in psychiatric clinics, and meeting partners in bars accounted for a substantial proportion of the variance in HIV risk behavior. CONCLUSIONS: These results suggest an urgent need for HIV prevention programs targeted at urban chronic mentally ill adults. Risk-producing characteristics of patient relationships and social networks should be addressed in the development of prevention interventions.

Adult↗
PubMed1994

Sexual sensation seeking: scale development and predicting AIDS-risk behavior among homosexually active men.

Sensation seeking, the propensity to prefer exciting, optimal, and novel stimulation or arousal, is a potential mediating factor in sexual risk for human immunodeficiency virus infection (HIV), the cause of acquired immunodeficiency syndrome (AIDS). However, the most widely used measure of sensation seeking, the Sensation Seeking Scale (Zuckerman, Kolin, Price, & Zoob, 1964), contains numerous culturally outdated items and items that do not pertain to sexual behavior. In this study, 106 homosexually active men completed newly developed measures of sensation seeking related to sexual and nonsexual experiences, as well as a measure of sexual compulsivity. Results show that the new scales were internally consistent and time-stable. Additional analyses demonstrated convergent, divergent, and discriminant validity for these scales, showing them to be of use as mediating variables in models of high-risk sexual behavior. Implications for HIV prevention and behavior change are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1994

The effects of HIV/AIDS intervention groups for high-risk women in urban clinics.

OBJECTIVE: This study reports the results of a behavior change intervention offered to women at high risk for human immunodeficiency virus (HIV) infection seen in an urban primary health care clinic. METHODS: Participants were 197 women randomly assigned to either an HIV/acquired immunodeficiency syndrome (AIDS) risk reduction group or a comparison group. Women in the HIV/AIDS intervention group attended five group sessions focusing on risk education; skills training in condom use, sexual assertiveness, problem solving, and risk trigger self-management; and peer support for change efforts. Women in the comparison group attended sessions on health topics unrelated to AIDS. RESULTS: At the 3-month follow-up, women in the HIV/AIDS intervention group had increased in sexual communication and negotiation skills. Unprotected sexual intercourse had declined significantly and condom use had increased from 26% to 56% of all intercourse occasions. Women in the comparison group showed no change. CONCLUSIONS: Socially disadvantaged women can be assisted in reducing their risk of contracting HIV infection. Risk reduction behavior change interventions should be offered routinely in primary health care clinics serving low-income and high-risk patients.

Adolescent↗
PubMed1993

Psychological interventions to prevent HIV infection are urgently needed. New priorities for behavioral research in the second decade of AIDS.

Behavior change remains the only means for primary prevention of HIV disease. Psychology should take a leading role in efforts to curtail the epidemic, but has not contributed to HIV prevention at a level proportionate to the urgency of the crisis. The authors propose an updated agenda for behavioral research on AIDS-HIV prevention implementing accelerated community trials of promising behavior change models, conducting trials of community-level interventions on a large scale and focused on populations most vulnerable to HIV infections, establishing partnerships between HIV research and community service organizations, integrating efforts from across psychology disciplines to advance and refine HIV prevention interventions, and mobilizing interdisciplinary HIV prevention resources and communication mechanisms to rapidly translate research findings to community and public policy arenas.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Culturally tailored HIV-AIDS risk-reduction messages targeted to African-American urban women: impact on risk sensitization and risk reduction.

African-American women recruited from low-income housing projects in Chicago (N = 106) were randomly assigned to view 1 of 3 20-min videotapes: a standard public health service tape on prevention of acquired immunodeficiency syndrome (AIDS), the same public health service tape but matching presenter and participant ethnicity and sex, or a tape that included the same content but was framed in a context specifically intended to increase cultural relevance. Participants who viewed the tapes presented by African-American women were significantly more sensitized to AIDS and were more likely to have discussed AIDS with friends, to be tested for human immunodeficiency virus (HIV) antibodies during the follow-up interval, and to request condoms at follow-up. These results support the use of culturally sensitive AIDS prevention messages targeted to specific populations, particularly to promote HIV-antibody testing.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Factors associated with severity of depression and high-risk sexual behavior among persons diagnosed with human immunodeficiency virus (HIV) infection.

Whereas some people appear to cope after learning that they have human immunodeficiency virus (HIV) infection, others experience depression and suicidal ideation. In this study, 142 persons with HIV infection were administered the Center for Epidemiological Studies Depression Scale (CES-D). High levels of depression were predicted by lower perceived social support, attributions that health was influenced more by chance, high-risk sexual behavior practices, and greater number of HIV illness symptoms and greater duration of time knowing of one's own positive serostatus. Ongoing high-risk sexual behavior practices were predicted by higher levels of recreational drug use and of depression. These findings highlight the need for improved mental health services for persons with HIV conditions.

Acquired Immunodeficiency Syndrome↗