An intersectional examination of the impact of COVID-stress and discrimination on college students' resilience and mental health.

Objective: To investigate the impact of COVID-stress and discrimination on mental health among a group of diverse college students using an intersectional framework. Participants: One thousand six hundred seventy-one undergraduate students (Mage = 20.42, SD = 2.74) were recruited from nine college campuses. Methods: Participants completed an online questionnaire assessing mental health symptoms, COVID-stress, and in-school discrimination. Hierarchical regressions and multi-group SEM path analysis were conducted to examine differences across intersectional identities. Results: Female-identifying students reported higher COVID-stress, anxiety and depressive symptoms, and lower resilience compared to males. COVID-stress and discrimination were highest among certain minoritized student groups. Using an intersectional framework, more COVID-stress and discrimination were associated with increased anxiety for almost all women of color. Unexpectedly, COVID-stress predicted anxiety symptoms for almost all male intersectional groups. Conclusions: Findings reaffirm the intersectional framework and highlight significant disparities in how students experience COVID-stress, discrimination, and mental health outcomes along dimensions of gender and race/ethnicity.

A Systematic Review of Intervention Studies That Address HIV-Related Stigmas Among US Healthcare Workers and Health Systems: Applying a Theory-Based Ontology to Link Intervention Types, Techniques, and Mechanisms of Action to Potential Effectiveness.

BACKGROUND: To end the HIV epidemic, we need to better understand how to address HIV-related stigmas in healthcare settings, specifically the common theoretical bases across interventions so that we can generalize about their potential effectiveness. PURPOSE: We describe theory-based components of stigma interventions by identifying their functions/types, techniques, and purported mechanisms of change. METHODS: This systematic review examined studies published by April 2021. We applied a transtheoretical ontology developed by the Human Behaviour Change Project, consisting of 9 intervention types (ITs), 93 behavior change techniques (BCTs), and 26 mechanisms of action (MOAs). We coded the frequency and calculated the potential effectiveness of each IT, BCT, and MOA. We evaluated study quality with a 10-item adapted tool. RESULTS: Among the nine highest quality studies, indicated by the use of an experimental design, the highest potentially effective IT was "Persuasion" (i.e. using communication to induce emotions and/or stimulate action; 66.7%, 4/6 studies). The highest potentially effective BCTs were "Behavioral practice/rehearsal" (i.e. to increase habit and skill) and "Salience of consequences" (i.e. to make consequences of behavior more memorable; each 100%, 3/3 studies). The highest potentially effective MOAs were "Knowledge" (i.e. awareness) and "Beliefs about capabilities" (i.e. self-efficacy; each 67%, 2/3 studies). CONCLUSIONS: By applying a behavior change ontology across studies, we synthesized theory-based findings on stigma interventions. Interventions typically combined more than one IT, BCT, and MOA. Practitioners and researchers can use our findings to better understand and select theory-based components of interventions, including areas for further evaluation, to expedite ending the HIV epidemic.

A Cascade Model of Sociodevelopmental Events Leading to Men's Perpetration of Violence Against Female Romantic Partners.

Conceptually driven by life history theory, the current study investigated a hypothesized hierarchy of behaviors leading to men's perpetration of violence in intimate relationships. Using a series of hierarchical regressions, we tested a causal cascade model on data provided by 114 men in a committed romantic relationship. The results supported the hypothesized hierarchy of sociodevelopmental events: (1) men's childhood experiences with their parents' parental effort predicted men's life history strategies; (2) men's life history strategies predicted men's behavioral self-regulation; (3) men's self-regulation predicted men's perceptions of partner infidelity risk; (4) perceptions of infidelity risk predicted men's frequency of engagement in nonviolent mate retention behaviors; (5) men's mate retention behaviors predicted men's frequency of partner-directed violence. The overall cascade model explained 36% of variance in men's partner-directed violence.

Sexual violence experiences among black gay, bisexual, and other men who have sex with men and transgender women in South African townships: contributing factors and implications for health.

This study examined experiences with sexual violence among Black African gay, bisexual, and other men who have sex with men (GBMSM) and transgender women (TGW) in townships surrounding Pretoria, South Africa. Of 81 GBMSM and TGWs interviewed, 17 reported to have experienced sexual violence perpetrated by other men. Qualitative analysis of interviews revealed the social and relational context of these experiences as well as their psychological and health consequences. The described context included single- and multiple-perpetrator attacks in private and public spaces, bias-motivated attacks, and violence from known partners. Several participants reported refusing propositions for sex as a reason for being victimized. HIV-positive individuals were overrepresented among survivors compared to the sample as a whole. Following victimization, participants described feelings of pain, fear, anger and self-blame. The results demonstrate the need for interventions designed to (a) prevent sexual violence against GBMSM and TGW in this population, and (b) reduce the negative psychological and health outcomes of sexual victimization. The discussion also highlights the need to examine more closely the link between experiences of sexual violence and risk for HIV infection.

Associations Between Alcohol Use and Intimate Partner Violence Among Men Who Have Sex with Men.

PURPOSE: Intimate partner violence (IPV) research among men who have sex with men (MSM) has primarily focused on the prevalence of IPV victimization and perpetration. Although alcohol use is a known trigger of IPV in opposite sex relationships, less is known about alcohol use and IPV perpetration and victimization in same-sex couples. The aim of this study was to examine associations between alcohol use and different types of IPV victimization and perpetration among MSM. METHODS: MSM in New York City were recruited at gay-friendly venues and events to participate in an online survey assessing sociodemographics, alcohol use, and victimization/perpetration of IPV with both regular and casual sex partners. Logistic regression was used to examine associations between alcohol use and different types of IPV victimization and perpetration. RESULTS: Among 189 participants, 103 (54.5%) reported experiencing at least one incidence of IPV perpetrated by a regular partner and 92 (48.7%) reported having perpetrated IPV against a regular partner in the past 12 months. Higher levels of alcohol use were significantly associated with (1) physical/sexual and HIV-related IPV victimization by a regular partner, (2) physical/sexual, monitoring, and controlling IPV victimization by a casual partner, (3) physical/sexual, emotional, controlling, and HIV-related IPV perpetration against a regular partner, and (4) physical/sexual and emotional IPV perpetration against a casual partner. CONCLUSIONS: The association of high levels of alcohol use with different types of IPV perpetration and IPV victimization suggests a need for targeted services that address the co-occurring issues of alcohol use and IPV.

A Clinical Home for Preexposure Prophylaxis: Diverse Health Care Providers' Perspectives on the "Purview Paradox".

BACKGROUND: One barrier to wider preexposure prophylaxis (PrEP) availability is uncertainty about the most appropriate providers and practice settings for offering PrEP. METHODS: The authors conducted in-depth interviews with 30 clinicians--primary care and HIV specialists--in the New York City (NYC) region to explore issues related to PrEP rollout, including who should provide it and in what settings. RESULTS: A diverse group favored offering PrEP in non-HIV specialty settings in order to reach high-risk HIV-negative individuals. Yet, for each clinical skill or ancillary service deemed important for providing PrEP--knowledge of the medications, ability to assess and counsel around sexual risk behavior, and ability to provide support for retention and medication adherence--participants were divided in whether they thought primary care providers/practices could achieve it. Five participants strongly favored providing PrEP in HIV care practices. CONCLUSION: Although there may be multiple "homes" for PrEP, implementation research is needed to identify the most effective delivery approaches.

Husband's esteem predicts his mate retention tactics.

Men sometimes enact mate retention tactics to thwart a partner's infidelity or prevent their defection from the relationship. These tactics include low-risk acts that render the current relationship more attractive by bestowing benefits on the woman, as well as cost-inflicting acts that render defection from the relationship risky or dangerous for her. Previous research has linked men's mate retention behavior with men's mate value (value as a current or potential partner) using women's reports. The current research addresses limitations of that research using self-reports and cross-spousal reports from 107 married couples concerning their self-esteem and their esteem for their partner. The results indicate that the level of esteem that wives have for their husbands is positively associated with their perception of their husband's use of positive inducements and negatively associated with their husband's self-reported use of cost-inflicting mate retention behaviors (i.e., Direct Guarding, Intersexual Negative Inducements, and Intrasexual Negative Inducements). The level of self-esteem reported by men was negatively associated with their self-reported direct guarding behavior. Discussion explores the possibility that esteem-both self-esteem and esteem from one's partner-functions as an internal gauge of relative mate value.

Age and sexual risk among Black men who have sex with men in South Africa: the mediating role of attitudes toward condoms.

The results of research linking age and sexual risk among men who have sex with men have been inconsistent. This study assessed the relationship between age and sexual risk among 193 Black men who have sex with men in Pretoria. Older men who have sex with men reported engaging in more frequent unprotected insertive anal intercourse. We examined whether components of Information-Motivation-Behavioral Skills model mediated this relationship. Results showed that (1) older age predicts less positive attitudes toward condoms, (2) less positive attitudes predict more frequent unprotected insertive anal intercourse, and (3) attitudes mediate the relationship between age and frequency of unprotected insertive anal intercourse. We consider two possible explanations for these findings: a developmental trajectory and a cohort effect.

Does fertility status influence impulsivity and risk taking in human females? Adaptive influences on intertemporal choice and risky decision making.

Informed by the research on adaptive decision making in other animal species, this study investigated human females' intertemporal and risky choices across the ovulatory cycle. We tested the hypothesis that at peak fertility, women who are exposed to environments that signal availability of higher quality mates (by viewing images of attractive males), become more impulsive and risk-seeking in economic decision tasks. To test this, we collected intertemporal and risky choice measures before and after exposure to images of either attractive males or neutral landscapes both at peak and low fertility conditions. The results showed an interaction between women's fertility status and image type, such that women at peak fertility viewing images of attractive men chose the smaller, sooner monetary reward option less than women at peak fertility viewing neutral images. Neither fertility status nor image type influenced risky choice. Thus, though exposure to images of men altered intertemporal choices at peak fertility, this occurred in the opposite direction than predicted--i.e., women at peak fertility became less impulsive. Nevertheless, the results of the current study provide evidence for shifts in preferences over the ovulatory cycle and opens future research on economic decision making.

Communicating HIV status in sexual interactions: assessing social cognitive constructs, situational factors, and individual characteristics among South African MSM.

This study assessed whether social cognitive constructs, situational factors, and individual characteristics were associated with communicating HIV status and whether communication was related to sexual risk behavior. A quota-sampling method stratified by age, race, and township was used to recruit 300 men who have sex with men to participate in a community-based survey in Pretoria in 2008. Participants reported characteristics of their last sexual encounter involving anal sex, including whether they or their partner had communicated their HIV status. Fifty-nine percent of participants reported that they or their partner had communicated their HIV status. HIV communication self-efficacy (aOR = 1.2, 95 % CI: 1.04-1.68), being with a steady partner (aOR = 0.36, 95 % CI: 0.19-0.67), and being Black (versus White; aOR = 0.08, 95 % CI: 0.03-0.27) were independently associated with communicating HIV status. Communicating HIV status was not associated with unprotected anal intercourse. HIV communication self-efficacy increases men's likelihood of communicating HIV status. Being with a steady partner and being Black reduces that likelihood. Communication about HIV status did not lead to safer sex.

Do women pretend orgasm to retain a mate?

The current study tested the hypothesis that women pretend orgasm as part of a broader strategy of mate retention. We obtained self-report data from 453 heterosexual women (M age, 21.8 years) in a long-term relationship (M length, 32.8 months) drawn from universities and surrounding communities in the southeastern United States. The results indicated that (1) women who perceived higher risk of partner infidelity were more likely to report pretending orgasm, (2) women who reported greater likelihood of pretending orgasm also reported performing more mate retention behaviors, and (3) women's perceptions of partner infidelity risk mediated the relationship between pretending orgasm and the performance of cost-inflicting mate retention behaviors, such as Intersexual Negative Inducements ("Flirted with someone in front of my partner") and Intrasexual Negative Inducements ("Yelled at a woman who looked at my partner"). Thus, pretending orgasm may be part of a broader strategy of mate retention performed by women who perceive higher risk of partner infidelity.

Expectancy and pharmacology influence the subjective effects of nicotine in a balanced-placebo design.

The expectancy and pharmacological effects of nicotine (0.60 mg) on memory and the subjective effects of cigarettes were examined by using a balanced-placebo design (i.e., expect either nicotine or no nicotine and receive either nicotine or no nicotine). A total of 120 college students who smoke were assigned to 1 of the 4 experimental groups, then rated the cigarettes on a number of dimensions and completed questionnaires on smoking urges, tension, and energy. Participants also completed tests of memory as well as predictions of memory. Pharmacology played a stronger role than expectancy in most ratings of the cigarettes, but significant effects of expectancy did emerge for feelings of increased wakefulness, concentration, calming, cigarette satisfaction, and hunger reduction. The presence of nicotine significantly reduced smoking urges, but expectancy alone reduced tension after smoking. Neither variable produced significant effects on memory or memory predictions. These findings demonstrate that nonpharmacological factors can play an important role in the self-reported effects of nicotine.