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M T Fullilove

Publications and source records attributed to M T Fullilove.

At least 37 records · Page 2Linked to original sources
PubMed1996

Quality and use of trauma histories obtained from psychiatric outpatients through mandated inquiry.

OBJECTIVE: A growing awareness of the sequelae of trauma has prompted clinical and administrative mandates that psychiatric assessments must include inquiry about whether patients have experienced trauma or abuse. This study was designed to assess how a trauma history obtained through mandated inquiry is recorded and how it is used in diagnostic formulation and treatment planning. METHODS: Histories of physical and sexual abuse and other trauma were reviewed in the charts of 180 outpatients receiving psychotherapy at an urban teaching hospital clinic. The extent and variety of traumatic experiences and the quality of clinicians' assessment of trauma histories were measured by a rating instrument developed for the study. RESULTS: Mandated inquiry led to the detection of histories of traumatic experiences for 72 patients (40 percent). The recognition of trauma did not trigger appropriate evaluation. Only 11 percent of clinicians mentioned posttraumatic stress disorder symptoms. Only one in ten charts of patients with histories of trauma contained diagnostic assessments or treatment plans that adequately incorporated the trauma history as a factor in the patient's presentation for treatment. CONCLUSIONS: Although mandated inquiry led to the detection of substantial abuse and trauma, this information was rarely used in assessment and treatment planning. Implementation of mandated inquiry should be accompanied by relevant education and supervision to ensure that clinicians understand the diagnostic and treatment implications of past trauma.

Adolescent↗
PubMed1996

Cognitive and emotional assessments of perceived risk for HIV among unmarried heterosexuals.

We examined perceived risk of contracting HIV using assessments of likelihood and worry in a probability sample of unmarried heterosexuals. Perceptions of the likelihood of contracting HIV and worry about HIV were only modestly correlated (r = .23), suggesting that they are different constructs. Far more respondents expressed worry (43%) than expressed the belief that they were at risk for HIV (9%). A significant proportion of the sample reported experiences that may have placed them at risk for HIV transmission. Demographic and psychosocial correlates of perceived likelihood and worry were examined in separate multivariate logistic analyses. Misconceptions about HIV transmission, a history of injection-drug-using sexual partners, and less education were associated with higher perceived likelihood of contracting HIV. Misconceptions, having multiple sexual partners in the past year, and a history of sexually transmitted diseases (STDs) were associated with high worry about HIV. Implications of the findings for correcting HIV-related misconceptions are discussed.

Adult↗
PubMed1994

Prevalence, incidence, and correlates of syphilis seroreactivity in multiethnic San Francisco neighborhoods.

To examine the extent of infection with syphilis in an inner-city community, we determined the prevalence, incidence, and correlates of syphilis seroreactivity in a representative sample of unmarried whites, African Americans, and Hispanics living in San Francisco during 1988 to 1989 and again 1 year later in 1989 to 1990. One thousand seven hundred seventy single men and women aged 20 to 44 were surveyed in a random household sample drawn from three neighborhoods of varying geographic and cultural characteristics. Syphilitic infection was determined by testing specimens with the microhemagglutination assay for antibodies to Treponema pallidum (MHA-TP). Of blood samples available from 1262 participants from the initial survey, 32 (2.5%) were MHA-TP reactive. After adjustment for age, a reactive syphilis serology was significantly predicted (P < 0.05) by African American race, homosexual activity (men), and less education. In homosexually active men, lifetime number of male sex partners and the presence of antibody to the human immunodeficiency virus (HIV) significantly predicted syphilis seroreactivity (P < 0.01). One year later, of 841 specimens available for testing, an additional 13 (1.5%) had become MHA-TP reactive. Eleven (85%) of the new cases were in heterosexual men and women. Although San Francisco citywide incidence data indicate that syphilis may be decreasing for the city as a whole, incidence data on a community level suggests that syphilitic infection is increasing in high-risk heterosexual communities. Thus, syphilis prevention programs should rely on serologic testing at the community level to plan effective intervention strategies.

Adult↗
PubMed1994

Correlates of condom use among black, Hispanic, and white heterosexuals in San Francisco: the AMEN longitudinal survey. AIDS in Multi-Ethnic Neighborhoods survey.

We examined correlates of condom use among heterosexual whites, blacks, and Hispanics (ages 20-45 years) with an human immunodeficiency virus (HIV) risk factor in a community-based longitudinal sample (San Francisco; n = 716). Lag models were used to examine hypothesized antecedents of condom use at wave 2. High levels of condom use were associated with labeling one's sexual behavior as risky for HIV infection, high levels of condom enjoyment and commitment to use condoms, good sexual communication practices, gender (trend), and marital status. The results support the need for wide-ranging intervention programs that stimulate people to make personal risk assessments, teach basic sexual skills, and direct those in need of intensive help to appropriate agencies.

Adult↗
PubMed1993

Crack cocaine use and high-risk behaviors among sexually active black adolescents.

The recent spread of crack cocaine use among inner-city teenagers has been accompanied by dramatic increases in juvenile delinquency and sexually transmitted diseases (STDs) among teenagers. This study examined the prevalence of five factors which promote STDs, including human immunodeficiency virus (HIV), among a sample of sexually active black adolescent crack users and non-users from the San Francisco Bay Area. Significant differences were observed between these groups with respect to history of engaging in sexual intercourse under the influence of drugs or alcohol, exchanging sexual favors for drugs or money, condom use in the most recent sexual encounter, and having five or more sexual partners in the last year. Approximately 63% of all respondents reported engaging in at least one of these risk behaviors. In multiple logistic regression analysis, reporting one or more of these STD/HIV risk behaviors was significantly associated with crack use and having one or more relatives who used drugs. Intervention efforts need to address both individual and environmental risk factors in order to reduce teens' risk for STDs, including HIV.

Adolescent↗
PubMed1992

Prevalence and correlates of herpes simplex infections. The population-based AIDS in Multiethnic Neighborhoods Study.

OBJECTIVE: To examine the extent and correlates of infection with herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in an inner-city community, we studied the prevalence of antibodies to these viruses and their association with risk behaviors in a representative sample of unmarried white, black, and Hispanic adults living in San Francisco, Calif. DESIGN: Cross-sectional, community-based, random household survey. PARTICIPANTS: In 1988 and 1989, we surveyed 1770 unmarried men and women aged 20 to 44 years from three San Francisco neighborhoods of varying geographic and cultural characteristics. MAIN OUTCOME MEASURES: HSV-1 and HSV-2 antibodies based on an immunodot assay using type-specific glycoproteins gG-1 and gG-2. RESULTS: Of blood samples from 1212 participants available for testing, 750 (62%) had HSV-1 antibodies and 400 (33%) had HSV-2 antibodies. After controlling for other variables, HSV-1 antibody was significantly correlated (P less than .05) with older age (in heterosexual men, women, and homosexually active men), less education (in heterosexual men and women), and Hispanic (especially those not born in the United States) or black race. HSV-2 antibody was significantly correlated (P less than .05) with female gender, number of lifetime sexual partners and older age (in heterosexual men and women), and low levels of education and black or Hispanic race (in women). Among those with antibody to HSV-2, only 28 (19%) of 149 men and 32 (13%) of 251 women reported a history of genital herpes. However, most men (62%) and women (84%) who reported a history of genital herpes had HSV-2 antibodies. We observed a similar pattern (low sensitivity and moderate specificity) for a history of facial herpes and the presence of HSV-1 antibodies. After controlling for other variables, HSV-2 antibodies were associated with a lower frequency of HSV-1 antibodies among homosexual men infected with the human immunodeficiency virus. CONCLUSIONS: HSV-1 antibodies were found in nearly two thirds of single urban adults and were most common among Hispanics not born in the United States. HSV-2 antibodies were found in one third of this population and were associated with risk behaviors for sexually transmitted diseases. For both facial and genital herpes infections, self-reporting of infection was very insensitive and moderately specific.

Adult↗
PubMed1992

Condom use in multi-ethnic neighborhoods of San Francisco: the population-based AMEN (AIDS in Multi-Ethnic Neighborhoods) Study.

We examined the prevalence and correlates of condom use in a community-based sample of unmarried heterosexual and gay/bisexual Whites, Blacks, and Hispanics (aged 20 to 44 years) in San Francisco (n = 1229). Only 9% of heterosexual males reported always using condoms, and fewer of those with multiple sexual partners (6%) reported always using condoms compared with those in monogamous relationships (12%). Much higher proportions of gay/bisexual men reported always using condoms (48%). Racial differences in condom use were observed only among women. Sexual communication and the sexual enjoyment value of condoms were consistent correlates of condom use across gender and sexual orientation, while other condom-related beliefs were significant predictors of condom use only for men. In general, condom promotion programs should build sexual communication skills, teach people how to enhance enjoyment with condoms, and reduce psychological barriers to condom acquisition and use.

Adult↗
PubMed1992

Risk for AIDS in multiethnic neighborhoods in San Francisco, California. The population-based AMEN Study.

To examine the actual and potential spread of human immunodeficiency virus (HIV) from an acquired immunodeficiency syndrome (AIDS) epicenter to surrounding neighborhoods, we studied the prevalence of the viral infection and AIDS risk behaviors from 1988 to 1989 in a representative sample of unmarried whites, African Americans, and Hispanics living in San Francisco. We surveyed 1,770 single men and women aged 20 to 44 years (a 64% response rate) in a random household sample drawn from 3 neighborhoods of varying geographic and cultural proximity to the Castro District where the San Francisco epidemic began. Of 1,369 with blood tests, 69 (5%) had HIV antibodies; all but 5 of these reported either homosexual activity (32% HIV-positive; 95% confidence interval [CI] = 23%, 41%), injection drug use (5% HIV-positive; CI = 1%, 14%), or both (59% HIV-positive; CI 42%, 74%). Homosexual activity was more common among white men than among African-American or Hispanic men, but the proportion of those infected was similar in the 3 races. Both the prevalence of homosexually active men and the proportion infected were much lower in the 2 more outlying neighborhoods. Risk behaviors in the past year for acquiring HIV heterosexually--sex with an HIV-infected person or homosexually active man or injection drug user, unprotected sexual intercourse with more than 4 partners, and (as a proxy) having a sexually transmitted disease--were assessed in 1,573 neighborhood residents who were themselves neither homosexually active men nor injection drug users. The prevalence of reporting at least 1 of these risk behaviors was 12% overall, and race-gender estimates ranged from 5% among Hispanic women to 21% among white women. We conclude that in San Francisco, infection with HIV is rare among people who are neither homosexually active nor injection drug users, but the potential for the use spread of infection is substantial, as 12% of this group reported important risk behaviors for acquiring the virus heterosexually.

Acquired Immunodeficiency Syndrome↗
PubMed1992

'Many are called...': participation by minority leaders in an AIDS intervention in San Francisco.

Though the AIDS epidemic has posed a significant threat to minority people, especially African Americans and Latinos, minority community response to the epidemic has lagged significantly behind the organized efforts initiated by the European-American gay community. To test the efficacy of an educational intervention in increasing the involvement of minority leaders in AIDS-related efforts, we identified and recruited 166 African-American and Latino leaders to participate in a randomized controlled trial. This report describes the identification and recruitment of leaders to the study. Overall, participation was low. Rates of participation were not associated with race but were significantly associated with category of leadership--that is, whether the individual was a religious leader, an agency director, an elected official, or an informal leader, with religious leaders least likely and agency directors most likely to participate. We discuss the implications of these findings for improving epidemic response in minority communities.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Women and AIDS.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1991

AIDS deaths in the Bronx 1983-1988: spatiotemporal analysis from a sociogeographic perspective.

"Patterns of AIDS deaths, in space and time, are examined for the populous Bronx section of New York City in view of the continuing massive destruction of housing and disruption of community which has affected the South Bronx since the early 1970s. Annual Bronx AIDS deaths are studied simultaneously in geographic space and in a dual 'social variate' space, and it is found that study of linked changes in each deeply illuminates patterns in both. This analysis reinforces a rapidly growing body of work which suggests control of AIDS in the United States, particularly prevention of a widespread and relentlessly rising heterosexual phase of the epidemic, may well prove impossible without a timely, general, and considerable program of reform and renewal for its disintegrating inner cities."

Acquired Immunodeficiency Syndrome↗
PubMed1990

Risk of sexually transmitted disease among black adolescent crack users in Oakland and San Francisco, Calif.

Crack cocaine is a smokable form of cocaine hydrochloride that has been associated with increases in admissions to drug treatment programs, and, recently, increases in the incidence of sexually transmitted diseases (STDs) among black teenagers. In an exploratory, cross-sectional study of the prevalence of risk behaviors that would promote the dissemination of STDs (including human immunodeficiency virus) among 222 black teenaged crack users, 41% of those interviewed reported a history of an STD. A history of an STD was more likely to be reported by girls (55%) than by boys (34%) and by those who combined crack use with sexual relations (51%) than those who did not (32%). The number of risk behaviors for STDs or human immunodeficiency virus reported by respondents (including failure to use a condom in one's most recent sexual encounter, having had a history of an STD, engaging in exchanges of sex for drugs or money, combining sexual activity with drug use, and reporting five or more sexual partners per year) was evaluated using multiple regression analysis stratified by gender. For girls, a history of selling crack and the number of reported risk behaviors (R = .46); for boys who chose the description "I don't know ahead of time if I'm going to have sex--it just happens" and the number of drugs used on a daily basis were associated with the number of reported risk behaviors (R = .31). Because of the impetuous nature of some crack-related sexual activity and because 76% of respondents acknowledged that they were either "very worried" or "somewhat worried" that they might get acquired immunodeficiency syndrome, it is possible that a program of widespread distribution of condoms in neighborhoods where crack use is prevalent might make it possible for the worried, impulsive crack user to practice "safer sex."

Adolescent↗
PubMed1990

Crack users: the new AIDS risk group?

Crack cocaine, a smokable form of cocaine hydrochloride, is now widely available in American inner cities. Reports of high rates of unprotected sexual activity among crack users, coupled with reports of high rates of sexually transmitted diseases (STDs), have raised fears that this population of drug users may soon be contracting and disseminating sexually transmitted HIV. In a study of 205 black adolescent crack users conducted in Oakland and San Francisco, California, 101 respondents (49% of the sample) who reported using crack in combination with sexual activity were examined. Those respondents who reported having a history of one or more STD were compared using discriminant analysis (DA). A successful discrimination (canonical correlation = 0.61, p = 0.000) identified five variables that distinguished those with a STD history from those with no STD history: gender (being female) (p = 0.000), frequency of marijuana use (p = 0.005), response to the question; "Do you plan for sex or does it just happen?" (p = 0.002), response to the statement, "I use drugs to get away from my problems" (0.029), and response to the question, "Do you agree that sex doesn't feel as good when you use a condom?" (p = 0.006). The selection of these variables was thought to represent an underlying passivity in the way that crack users who combine crack use with sex approach sexual activity.

Acquired Immunodeficiency Syndrome↗