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Biomedical subjects

J Richters

Publications and source records attributed to J Richters.

18 recordsLinked to original sources
PubMed2003

Seroconversion in context.

This paper describes the accounts that homosexually active men give of their HIV seroconversion and interrogates these accounts for risk discourses. In particular, this paper asks whether the risk discourses of HIV researchers and educators are present in the men's narratives of their own seroconversion. Such discourses make reference to 'unsafe' sex--particularly the practice of unprotected anal intercourse, numbers of sexual partners or 'promiscuity', and the disinhibiting effect of drugs and alcohol. The data are drawn from an ongoing case-series study of seroconversion in which men who had seroconverted were asked to give an account of the occasion on which they believe they were infected. A number of themes were identified in the men's accounts. The men's descriptions of what they believe to be the seroconversion event indicate that their attributions, i.e., the reasons they give for their HIV infection, vary depending on the context. Within regular relationships, breakdown of negotiated safety, love and intimacy, and fatalism were among the explanations given. Seroconversion attributed to casual sexual encounters was more likely to be explained in terms of pleasure, lack of control, and with reference to particular sexual settings. The ways in which men understood their HIV infection were informed both by the risk discourse of HIV researchers and also by the discourses of love and pleasure, as well as that of control.

Adult↗
PubMed2002

Women in contact with Sydney's gay and lesbian community: sexual identity, practice and HIV risks.

Total rates are low, but sex with a man remains the main risk for HIV transmission to women in Australia. In February 1998, 774 women in contact with gay, bisexual and lesbian communities completed a two-page questionnaire. Almost all respondents had some social contact with gay men. Two-thirds (503) thought of themselves as lesbian/dyke/homosexual/gay, 13% (100) as bisexual and 17% (133) as heterosexual/straight. In total, 212 women (27%) said they had ever had sex with a gay or bisexual man; 51 women (7%) had done so in the past six months. About 2% of the lesbians said they had recently had sex with a gay/bi man, as had 8% of the heterosexuals and 25% of the bisexuals; 25 women had recently had unprotected vaginal or anal intercourse with a male gay/bi partner. Forty-eight women (6%) had done sex work. Asked about drug use, 61 women (8%) said they had injected in the past six months. Twenty-three women had shared injecting equipment with someone, and five had shared with a gay/bi man. Compared with other women, these women have high rates of injecting drug use. If they have sex with men, these men are more likely to be gay or bisexual than are the male sexual partners of women moving in largely heterosexual milieux. For a case of so-called 'heterosexual' transmission of HIV to occur, neither person need be heterosexual.

Bisexuality↗
PubMed2000

Age at first intercourse in an Australian national sample of technical college students.

OBJECTIVE: This study aims to broaden the current body of knowledge regarding the sexual behaviour of young Australians by examining the age and correlates of age of first intercourse in a national sample of Technical and Further Education apprentices. METHOD: In 1995, students at randomly selected technical colleges in Australia were surveyed on HIV-related issues. Questionnaires were administered to a stratified cluster sample of automotive, hairdressing and commercial cookery apprentices. Respondents were asked the age at which they first had heterosexual vaginal or anal intercourse. RESULTS: Of 4,055 respondents aged 15-24 years, 3,848 answered the question; 3,195 (83%) had had intercourse. Males and females did not differ significantly. Median age at first intercourse was 16 (range 12-23). In multivariate analysis, older age at first intercourse was associated with: greater age at interview; higher school education; church attendance; and State of residence. The model, however, accounted for only 14% of the variance in age at first intercourse. CONCLUSIONS AND IMPLICATIONS: In this sample, those apprentices who completed secondary school became sexually active later on average than those who left before the end of Year 10. For sex education to occur before sexual initiation, it needs to be offered in primary schools and the first year of high school (aged 11-13 years). Further, as technical college students are likely to initiate sex earlier than their age mates still at school, colleges may be in a position to take responsibility for the continuing sexual education of this group, especially for those students entering college at 15 or 16 years of age.

Adolescent↗
PubMed2000

Condom use and 'withdrawal': exploring gay men's practice of anal intercourse.

Some gay men who have unprotected anal intercourse avoid ejaculation-they practise 'withdrawal'. Using data collected in 1997 from a sample of Sydney gay men (n=625), we explored the relation between men's practice of ejaculation and their use of condoms. We also investigated whether men who had unprotected withdrawal but not unprotected ejaculation were more likely to think unprotected withdrawal was safe, liked condoms less, liked anal intercourse more, or were more sexually adventurous. Considering separately insertive and receptive anal intercourse with regular and with casual partners, we found that the majority of men who practised unprotected withdrawal also practised unprotected ejaculation. Of those whose only unprotected sex was withdrawal ('true withdrawers'), most never used condoms (they did not also have protected sex with ejaculation). True withdrawers were compared with men who had unprotected ejaculation, who always used condoms, who had no anal sex and who had no partners. Those who were true withdrawers with casual partners were more likely to believe withdrawal was safe; no group effects were found with regular partners. No significant differences in condom attitudes were found. True withdrawers with regular partners liked anal intercourse less than other men, but true withdrawers with casual partners were indistinguishable from those who had unprotected ejaculation. True withdrawers did not differ in sexual adventurousness from other men who had anal intercourse. Most withdrawers avoided anal sex with ejaculation rather than use condoms. Converting them into reliable condom users may be a considerable challenge for health promotion.

Adult↗
PubMed1995

Test-retest reliability of the Diagnostic Interview Schedule for Children (DISC 2.1). Parent, child, and combined algorithms.

BACKGROUND: Previous research has not compared the psychometric properties of diagnostic interviews of community samples and clinically referred subjects within a single study. As part of a multisite cooperative agreement study funded by the National Institute of Mental Health, 97 families with clinically referred children and 278 families identified through community sampling procedures participated in a test-retest study of version 2.1 of the Diagnostic Interview Schedule for Children (DISC 2.1). METHODS: The DISC was separately administered to children and parents, and diagnoses were derived from computer algorithms keyed to DSM-III-R criteria. Three sets of diagnoses were obtained, based on parent information only (DISC-P), child information only (DISC-C), and information from either or both (DISC-PC). RESULTS: Test-retest reliabilities of the DISC-PC ranged from moderate to substantial for diagnoses in the clinical sample. Test-retest kappa coefficients were higher for the clinical sample than for the community sample. The DISC-PC algorithm generally had higher reliabilities than the algorithms that relied on single informants. Unreliability was primarily due to diagnostic attenuation at time 2. Attenuation was greatest among child informants and less severe cases and in the community sample. CONCLUSIONS: Test-retest reliability findings were consistent with or superior to those reported in previous studies. Results support the usefulness of the DISC in further clinical and epidemiologic research; however, closely spaced or repeated DISC interviews may result in significant diagnostic attenuation on retest. Further studies of the test-retest attenuation phenomena are needed, including careful examination of the child, family, and illness characteristics of diagnostic stability.

Adolescent↗
PubMed1995

The bioethics tabloids: how professional ethicists have fallen for the myth of tertiary transmitted heterosexual AIDS.

The hysteria and misconceptions about AIDS which are fostered and held by the popular press have been accepted uncritically by many bioethicists, who have not bothered to explore popular empirical claims in sufficient depth. As a result, and because ethicists attempt to sell moral problems in a manner not much different from the way the popular press attempt to sell newspapers, artificial dilemmas have been produced in professional journals. We concentrate on just one popular misconception about AIDS--that the heterosexual incidence of the syndrome is widespread--and show how bioethicists' unreflective acceptance of this myth has led them to make conceptual and practical errors.

Acquired Immunodeficiency Syndrome↗
PubMed1994

DSM-IV field trials for attention deficit hyperactivity disorder in children and adolescents.

OBJECTIVE: Optimal diagnostic thresholds were determined for DSM-IV attention deficit hyperactivity disorder, and the psychometric properties were compared to alternative definitions. METHOD: Structured diagnostic interviews of multiple informants for 380 clinic-referred youths aged 4-17 years were conducted. In addition, standardized clinicians' validation diagnoses of attention deficit disorder were obtained to assess agreement with clinical judgment. Measures of impairment were obtained to assess the accuracy of identifying youth with an impairing condition. RESULTS: Three subtypes of attention deficit hyperactivity disorder (predominantly inattentive, predominantly hyperactive-impulsive, and combined types) were distinguished on the basis of the degree of deviance on separate dimensions of inattention and hyperactivity-impulsivity. These three subtypes were found to differ in terms of types of impairment, age, and sex ratio, but not ethnicity. In terms of case identification of attention deficit hyperactivity disorder, DSM-IV was found to be very similar to DSM-III-R, except that DSM-IV identified more impaired girls and preschool children. CONCLUSIONS: These results support the decision to subdivide the heterogeneous category of DSM-III-R attention deficit hyperactivity disorder into three subtypes. The resulting DSM-IV definition appears to be somewhat less biased toward the symptom pattern typical of elementary school boys.

Adolescent↗
PubMed1993

Anxiety and depressive disorders in attention deficit disorder with hyperactivity: new findings.

OBJECTIVE: The authors examined the discriminant validity of the diagnosis of attention deficit disorder with hyperactivity. METHOD: They used standardized rating scales of life stresses and child and family functioning to assess psychosocial and family risk factors in 47 children who had the diagnosis of attention deficit disorder with hyperactivity, a matched group of 47 children in the community, and a matched group of 47 children seen in a psychiatric clinic. RESULTS: Children who had the diagnosis of attention deficit disorder and children in the psychiatric clinic reported significantly more depression and anxiety than did the children in the community; furthermore, children diagnosed as having attention deficit disorder with hyperactivity had more externalizing symptoms than did children in the psychiatric clinic. Children diagnosed as having attention deficit disorder with hyperactivity plus a comorbid anxiety or depressive disorder had higher levels of coexisting life stresses and parental symptoms than did children who had the single diagnosis of attention deficit disorder with hyperactivity. CONCLUSIONS: These results underscore the need for future studies to carefully assess children diagnosed as having attention deficit disorder with hyperactivity for concurrent psychiatric disorders as well as family and psychosocial stressors that may contribute to childhood symptoms. Such information is essential because different subtypes of attention deficit disorder with comorbid disorders may arise from different etiologic pathways, may require varying treatment options, and may foreshadow different eventual outcomes.

Anxiety Disorders↗
PubMed1993

Changing the agenda.

Explore the source record for details and available documents.

Evaluation Studies as Topic↗
PubMed1991

Child psychopathology and environmental influences: discrete life events versus ongoing adversity.

Patterns of exposure to distinct types of life stressors were compared between 134 children attending a military child psychiatric clinic and a matched military community control sample. Compared with the community sample, clinic-referred children had experienced significantly higher levels of normative stressful events as well as events confounded with their own adjustment and events related to parental psychosocial functioning. Differences in levels of normative stressful events were no longer significant, however, when controlling for events related to parental functioning. Ratings of stressful events during the past year significantly underestimated the lifetime stress exposure differences between clinic and community control children. Although normative stressful events, parent-related events, and parent symptomatology ratings were significantly related to child behavior problem ratings, normative stressful events did not contribute to predictions of child behavior problems beyond the variance attributable to parent-related events and parent symptomatology. Implications of these findings for life stress and child maladjustment research are discussed.

Adaptation, Psychological↗
PubMed1989

Depressed mothers' judgments about their children: an examination of the depression-distortion hypothesis.

The belief that depressed mothers have distorted perceptions of their children's problems has gained considerable currency in recent years. The empirical basis for this belief at present amounts to little more than reliable demonstrations that depressed mothers tend to report more behavior problems in their children than do nondepressed mothers. An obvious alternative to the distortion interpretation is that depressed mothers are accurate about their children's behavior problems. We examined these competing models by comparing teachers' ratings of children with ratings provided by their mothers, who varied on the dimensions of depressed mood, depressed clinical state, and history of depression. Mothers' and teachers' ratings yielded substantially similar portraits of child behavior problems at the group level, with children of in-remission and in-episode mothers manifesting significantly higher levels of behavior problems than children of control mothers. Moreover, agreement between mothers and teachers was in the moderate range for all index groups and did not differ significantly from the mean level of mother-teacher agreement reported by other investigators based on unselected samples. The limitations of these findings and of earlier reports for assessing a depression----distortion influence on mothers' ratings of their children are considered.

Adult↗
PubMedDate not supplied

How often do condoms break or slip off in use?

Men attending 3 sexually transmissible disease clinics and a university health service in Sydney were given a questionnaire asking how many condoms they had used in the past year and how many broke during application or use or slipped off. Respondents were 544 men aged 18 to 54 years. Of these, 402 men reported using 13,691 condoms for vaginal or anal intercourse; 7.3% reportedly broke during application or use and 4.4% slipped off. Men having sex with men reported slightly higher slippage rates than those having sex with women. Breakage and slippage were unevenly distributed among the sample: a few men experienced very high failure rates. A volunteer subsample reported 3 months later on condoms supplied to them: 36 men used 529 condoms, of which 2.8% broke during application or use and 3.4% slipped off. Many of these failures pose no risk to the user, especially those occurring during application, as long as they are noticed at the time, but failure may discourage future use. Research is needed to identify user behaviours related to breakage.

Adolescent↗
PubMedDate not supplied

Why do condoms break or slip off in use? An exploratory study.

Men attending 3 sexually transmissible disease clinics and a university health clinic in Sydney, Australia, were invited to complete a questionnaire on their use of condoms. Respondents were 108 male condom user volunteers aged 18 to 62 years; in the last five years 47 had had sex with men, 18 with both men and women and 43 only with women. They reported using a total of 4809 condoms in the previous 12 months (condoms worn by a male partner were not included). The overall breakage rate was 4.9% (including condoms breaking during application), while 3.1% of condoms reportedly slipped off. On a multivariate analysis, condom breakage correlated with: (1) male sexual partner(s), (2) infrequent condom use, (3) rolling the condom on as per conventional instructions (modified application methods appeared protective) and (4) having trouble with condoms partially slipping. Factors associated with condoms slipping off were (1) young age, (2) being circumcised, (3) having less life-time condom experience, (4) rolling the condom on conventionally, and (5) having trouble with condoms partially slipping. Few men used inappropriate lubricants and no association between lubricant type and breakage was found. Though common among our respondents, negative attitudes towards condoms, loss of erection during condom application or use, finding condoms uncomfortable, and prolonged sexual intercourse were not related to success in use. Almost half (49%) of the men reported having deliberately removed a condom after the beginning of intercourse; 17% had done so 3 or more times. Counselling protocols should acknowledge the complexity of condom use.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗