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PubMed2003

'You can't tell by looking': pilot study of a community-based intervention to detect asymptomatic sexually transmitted infections.

Innovative and non-stigmatizing interventions are required to reduce ethnic inequalities in rates of sexually transmitted infections among young people. We therefore designed an intervention, 'You can't tell by looking,' which combined health promotion with testing for gonorrhoea and chlamydia using nucleic acid amplification technology and treatment and partner notification delivered in the non-clinical settings. One hundred and eighty-one participants were seen in 13 sessions in local further education colleges. Forty-three percent of participants were from Black Caribbean or Black Other ethnic groups and 39% were Black African: 125 of 181 participants were sexually active and 109 of these (87%) provided a urine specimen. 10/109 (9.2%, 95% confidence interval 4.5-16.2%) samples were confirmed positive for Chlamydia trachomatis and two were also positive for Neisseria gonorrhoeae. Only 7% of those tested found it embarrassing. The intervention was both feasible and acceptable to young people. It could be tested in a wider variety of non-clinical settings and evaluated in a cluster randomized trial.

Adolescent↗
PubMed2006

Facial atrophy in HIV-related fat redistribution syndrome: a plastic surgical perspective on treatment options and a look to the future.

Approximately 50% of patients on highly active antiretroviral therapy (HAART) develop lipodystrophy with central and visceral fat accumulation and/or facial and limb atrophy. Although the exact mechanisms of this are not fully understood, the facial atrophy encountered is secondary to atrophy of the subcutaneous fat, and not the deeper fat pads, as has been suggested. More recently, the above features in combination with hyperlipidaemia and insulin resistance have been described and are referred to as HIV-related fat redistribution syndrome. This review looks at treatment options available for this stigmatizing condition.

Atrophy↗
PubMed2006

Misconceptions about HIV transmission, stigma and willingness to take sexual risks in southwestern China.

Based on data from a population-based survey conducted in 2003 in a province in southwestern China, we provide data on knowledge about HIV transmission, HIV stigmatizing attitudes, and willingness to take HIV-related risks. There were widespread misconceptions, especially among females, about how HIV is transmitted and negative feelings toward someone with HIV. There was considerable willingness to take more sexual risks (not using a condom; nondisclosure of HIV seropositive status) with a secondary than with a primary sexual partner. The misconceptions and stigma surrounding HIV may make it difficult to focus on HIV as a 'disease' as opposed to a 'social malady' for survey participants.

Adolescent↗
PubMed2006

How much does heterosexual commercial sex contribute to India's HIV epidemic?

Through a search, we identified five models of India's HIV epidemic, all of which articulate the hypothesis that heterosexual commercial sex drives India's HIV epidemic. All five models assume more female sex workers (FSWs) than have been mapped (counted), and more than can be inferred from men's sexual behaviour. With best and highest plausible evidence-based estimates (15-20% of 300,000-700,000 FSWs are HIV-positive; FSWs have 570 client contacts per year; clients use condoms with 60-75% of FSW contacts; and the rate of HIV transmission from FSWs to clients is 0.0011-0.002 per unprotected contact), FSWs and clients account for 2-15% of HIV-infected adults, far less than model-based estimates of 44-68%. Overestimating the contribution of commercial sex to India's HIV epidemic misleads prevention programmes to ignore other risks, and promotes the stigmatizing assumption that HIV infection is a sign of immoral behaviour.

Acquired Immunodeficiency Syndrome↗
PubMed2006

HIV/AIDS, psychiatric disorder and sexual assault in Transkei: a case report.

HIV infection and psychiatric disorders have a complex relationship. HIV infection could lead to psychiatric disorders, and psychiatric patients are more vulnerable to HIV infection. HIV is not only an illness which is associated with stigmatization and discrimination, but also has several risks attached including physical and sexual abuse. There is a scarcity of literature on HIV, mental illness and sexual assault although they are a common trio. The author describes an HIV-positive woman with a psychiatric disorder. She suffered from AIDS and periodic psychotic epidsodes. On a day when she had such an episode she became a rape victim. The history, and physical and genital examination has been described. The need for further research in the area of HIV/AIDS and mental health has been discussed. Preventive strategies have been recommended for HIV-infected individuals in poor health resource settings.

Adult↗
PubMed2000

Alteration of the self-incompatibility phenotype in Brassica by transformation of the antisense SLG gene.

Self-incompatible (SI) Brassica rapa (syn. B. campestris) was transformed with an antisense SLG gene by using SLG8 cDNA isolated from the B. campestris S8 homozygote. Two transformed lines were obtained and analyzed. Northern blot and Western blot analyses revealed that endogenous SLG and SRK were greatly reduced of the transcriptional and translational levels in the transformant. Pollination experiments confirmed that their SI phenotype had broken down. In addition, the progeny with the antisense SLG gene, resulting from self- or cross-pollination of the transgenic plant, also showed the self-compatible phenotype. The breakdown of SI in the tranformants was due to the change in property of the stigma and not of the pollen. These results provide strong evidence that SLG and/or SRK is implicated in the pollen-stigma recognition of SI and that they act only as stigmatic factors.

Brassica↗
PubMed1995

Identification and management of inherited cancer susceptibility.

Identification of inherited cancer-predisposing genes offers opportunities for cancer prevention. Inherited susceptibility genes have been identified, primarily through studies of unusual cancer cases and families but also through general population studies. Examples include the RB1 gene for retinoblastoma; the WT1 gene for Wilms' tumor; germline p53 mutations in families with the Li-Fraumeni syndrome; the NF1 and NF2 genes for neuroblastomatosis, types 1 and 2; the VHL gene for renal cancer and other tumors associated with Von Hippel-Lindau disease; the APC gene for adenomatous polyposis coli; the BRCA1 gene for hereditary breast and ovarian cancer; and the mismatch repair genes for colon and other common cancers. For some cancers, identification of gene carriers might be beneficial for targeting screening and chemopreventive interventions. On the other hand, predisposition testing for cancer has the potential for harm from loss of insurability and employability, psychological distress, social stigmatization and other adverse effects. Research is needed to identify predisposition testing procedures that maximize benefits while minimizing harm to subjects. Chemoprevention trials in genetically susceptible populations offer the prospect of finding effective methods of reducing future cancer risk.

Disease Susceptibility↗
PubMed2001

Managing schizophrenia: an update.

Atypical antipsychotic drugs offer hope to schizophrenics and their families. Controversy continues over their cost-effectiveness but patient surveys suggest increased compliance and thus improved mental health. This article reviews schizophrenia management, exploring the consequences of failing to adopt modern therapies in hampering compliance and stigmatizing the mentally ill.

Antipsychotic Agents↗
PubMed1993

AIDS and families: cultural, psychosocial, and functional impacts.

AIDS has touched the nation's families on a number of levels. More than a decade into the epidemic, it is clear that the cultural, psychosocial, and functional impact of AIDS stretches beyond that on our traditional concept of kin to a broader view of family. At the cultural level AIDS has challenged our notions of who is and functions as a family, while also shaping our behaviors and language. Within families, the psychosocial impact of a family member having a stigmatized illness generates a range of emotional responses. While certain of these responses are common to all families, they will also vary by the family constellation affected. At the functional level we see an illness in which persons other than kin often play important caregiving roles. In all family types family caregiving for persons with AIDS brings about role reconfiguration, financial, and other impacts.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Dating people with anorexia nervosa and bulimia nervosa: attitudes and beliefs of university students.

Attitudes and beliefs about dating people with eating disorders were investigated in men and women using a questionnaire administered to 752 university students. Students believed that people with anorexia nervosa and bulimia nervosa had a difficult time dating, dates would involve conflict, and dating would be a negative experience. Students were more comfortable in casual interactions than more serious dating activities with people with anorexia nervosa and bulimia nervosa. Men were somewhat comfortable dating people with anorexia nervosa or bulimia nervosa, but less so for obesity. Most students believed dating people with anorexia nervosa and bulimia nervosa would not be a positive experience, and men stigmatized people with eating disorders differently than did women.

Adult↗
PubMed2000

Exotic dancing and health.

The health and safety of women who work as exotic dancers are firmly embedded within the social organization of the strip club and the broader social, economic and political context of the work of exotic dancing. Exotic dancers in this study expressed health concerns associated with: the effects of costuming and appearance requirements; dirty work environments; problems due to stigmatization, sexual harassment and assault; and police disinterest or victim blaming. The balance between benefits and hazards related to exotic dancing is influenced not only by the personal choices made by dancers, but also by the organization of the strip club and the broader context within which exotic dancing takes place.

Adolescent↗
PubMed2000

Pain and depression experienced by women with interstitial cystitis.

The goal of this study was to better understand the experience of women suffering from interstitial cystitis (IC), a chronic pain condition that has, as of yet, received little attention from psychosocial investigators. Eighty women with IC participated. The results from this study demonstrate that, in addition to frequency of voiding (the hallmark symptom of the disorder), IC sufferers also endure significant pain and depression. Levels of pain experienced by IC patients during their most painful flares exceed levels of pain experienced by other chronic pain patients. Similarly, levels of depression experienced by IC patients exceed those evidenced by the general population and by other populations of chronic pain patients. Furthermore, the pain and depression experienced by IC patients may be predicted by cognitive factors. Severity of pain is associated with self-efficacy for coping with pain. Severity of depression is associated with pain, self-efficacy for coping with pain, and self-stigmatization.

Adaptation, Psychological↗
PubMed2004

Universal prenatal HIV screening: patient attitudes and perceptions.

In 1995, Center for Disease Control guidelines were modified to replace targeted HIV screening of pregnant women with universal screening. Public health scholars have argued that one rationale for universal screening is to reduce the potential stigmatization of women of color and lower socioeconomic status who are typically targeted under selective screening. Here, we examine whether experiences and impressions of prenatal screening differ across socioeconomic and racial lines. Data are drawn from an NIH-funded pilot study of 353 pregnant women across several sites in Connecticut, a state with unusually strong prenatal HIV screening laws. We find no significant differences on testing protocols and attitudes toward mandatory HIV screening. However, minority and lower socioeconomic status women are more likely (1) to understand the screening law, (2) to report that their doctor stresses the importance of the test, and (3) to express much higher levels of concern about the confidentiality of the test.

Adolescent↗
PubMed2004

Access to women's health care: a qualitative study of barriers perceived by homeless women.

Homelessness is an escalating national problem and women are disproportionately affected. Nevertheless, few studies have focused on the special circumstances associated with being a homeless woman. For instance, while both genders experience serious barriers to obtaining health care, homeless women face an additional burden by virtue of their sexual and reproductive health needs. The current study was conducted as the first stage of a qualitative/quantitative investigation of homeless women's access and barriers to family planning and women's health care. We interviewed 47 homeless women of diverse ages and ethnic backgrounds. A qualitative approach was initially taken to explore the factors homeless women themselves perceive as barriers to their use of birth control and women's health services, and factors they believe would facilitate their use. Key findings are that health is not a priority for homeless women, that transportation and scheduling can be particularly burdensome for homeless women, and that being homeless leads some to feel stigmatized by health care providers. Despite being homeless, having children was extremely important to the women in our study. At the same time, those interested in contraception confronted significant barriers in their efforts to prevent pregnancies. We conclude with suggested interventions that would make general, gynecological, and reproductive health care more accessible to homeless women.

Adolescent↗
PubMed2005

Serostatus disclosure to sexual partners by HIV-infected women before and after the advent of HAART.

HIV-positive individuals have been encouraged by public health officials to disclose their HIV status to sexual partners. In deciding what to do, however, they must weigh what they see as the potential costs and benefits of disclosing or not disclosing. In the present report we examine the reasons women offer for disclosing or not disclosing their serostatus and the reactions to that disclosure among two matched samples of HIV-infected women. The first sample was interviewed in 1994-1996, before the widespread availability of HAART; while the second sample was interviewed from 2000-2003 after these medications were widely in use. The findings reveal striking similarities between the two time periods in women's reasons for sharing or not sharing their status with partners, and the reactions to disclosure they experienced. The reconceptualization of AIDS as a chronic illness, rather than an acute fatal one, did not appear to have diminished women's felt responsibility to share their diagnosis with potential sexual partners nor their fear that disclosure would be met with rejection. The data revealed that disclosure remains a highly stressful event for HIV-infected women and that they experience considerable emotional suffering as a result of the diminished sense of self-worth and physical attractiveness brought about by their diagnosis. These findings suggest that intervention efforts toward reducing the stigmatization of HIV/AIDS and for assisting women to manage the stress of disclosure and non-disclosure and address women's feelings of self-worth continue to be needed despite the advent of HAART.

Adult↗
PubMed1995

Effects of the mental illness label in 1993: acceptance and rejection in the community.

Effects of the mental illness label in obtaining community accommodation were examined, in a sample of 160 individuals advertising rooms or flats for rent in two Canadian cities, Windsor and London, Ontario, and in Detroit, Michigan. Telephone calls, for half the sample, made simple enquiries as to availability; for the other half, similar enquiries were made by an individual ostensibly receiving psychiatric treatment but soon to require accommodation. In the latter condition, rooms were significantly more likely to be described as unavailable. Comparisons are made to similar, previous research, and to current perspectives about community reactions to stigmatizing conditions.

Attitude to Health↗
PubMed1976

Code switching and sexual orientation: a test of Bernstein's sociolinguistic theory.

Bernstein's theory was tested in the homosexual's "closed" community to determine code-switching ability and its relationship to jargon. Subjects told a story based on homoerotic photographs where knowledge of sexual orientation was varied. Rather than finding the restricted code associated with in-group communication, an analysis of data trends (since all hypotheses were rejected) suggests that homosexual hemophyly encouraged elaboration, and status differentiation resulted in a more restricted code. Story length was the most significant variable across groups. Some of Bernstein's theoretical explanations require modification to account for subjects' behavior in stigmatized social groups.

Adolescent↗
PubMed1981

Pseudotranssexualism: iatrogenic gender dysphoria.

Individuals who wish sexual reassignment can be classified according to clinical entities. It is essential to recognize which clinical entities promote gender dysphoria. A complication arising in the intensive psychotherapy of a woman unhappy with her biologic sex is presented. A 32-year-old homosexual woman entered treatment with a female therapist for depression. Despite occasional fantasies of impregnating her therapist, the patient at first demonstrated no gender dysphoria. When her therapist actually did become pregnant, however, the patient began consciously to wish that she herself were male and stigmatized her homosexuality. During a two-week separation in treatment, the patient actively sought sexual reassignment. The role of eroticized transference is discussed to explain the emergency of gender dysphoria.

Adult↗