Direct and vicarious exposure to healthcare discrimination and erasure among transgender and gender independent individuals: Testing the indirect effect of mistrust in healthcare on utilization behaviors.

RATIONALE: Direct exposure to gender identity-related discrimination and erasure among the transgender and gender independent (TGI) population are associated with healthcare underutilization, which may further exacerbate the health disparities that exist between this population and cisgender individuals in the United States (U.S.). Although the impacts of direct exposure to healthcare discrimination and erasure may have on TGI individuals are known, exposure to such harm vicariously (i.e., through observation or report) is underexplored. OBJECTIVE: The present study examined the relationships among direct and vicarious gender identity-related healthcare discrimination and erasure exposure and past-year healthcare utilization. METHOD: Gender identity-based mistrust in healthcare was also assessed, as a mechanism through which direct and vicarious gender identity-related healthcare discrimination and erasure predict healthcare utilization behaviors among a sample (N = 385) of TGI adults in the U.S., aged 18 to 71 recruited online. RESULTS: Results indicated direct lifetime and vicarious healthcare discrimination and erasure exposure significantly predicted past-year healthcare underutilization when participants anticipated encountering gender identity-related healthcare discrimination. Mediational analyses indicated that higher levels of exposure to direct lifetime and vicarious healthcare discrimination and erasure were related to higher levels of mistrust in healthcare, through which past-year underutilization was significantly related. CONCLUSIONS: These findings are vital to informing healthcare practice and policy initiatives aimed at ensuring the barriers that deleteriously influence the accessibility of healthcare among TGI individuals are ameliorated.

Perceptions of African American Youth and Adults Regarding Tobacco Use-Related Factors in Their Community: A Mixed-Methods Approach in Richmond, Virginia.

INTRODUCTION: The US Food and Drug Administration is poised to restrict the availability of menthol cigarettes and flavored cigars, products disproportionately used by Black/African American (B/AA) individuals. We examined B/AA youth and adult perceptions regarding factors contributing to tobacco use, as well as prevention/cessation resources. METHODS: In 2 mixed-methods studies in Richmond, Virginia, we conducted cross-sectional surveys among youth (n = 201) and adult (n = 212) individuals who were primarily B/AA and reported past 30-day cigar smoking or nontobacco use, followed by focus groups with a subset (youth: n = 30; adults: n = 24). Focus groups were analyzed using a thematic analysis framework, and descriptive survey data provided context to themes. RESULTS: Among focus group participants, 20% of youth and 75% of adults reported current cigar smoking. Six themes emerged across the groups: advertising/brands, sensory experiences, costs, social factors, youth-related factors, and dependence/cessation. Youth and adults perceived cigars as popular; cigar use was attributed to targeted advertising, flavors, affordability, and accessibility. While adults expressed concern regarding youth tobacco use, youth did not perceive tobacco prevention programs as helpful. Adults and youth reported limited access to community tobacco prevention/cessation programs. DISCUSSION: Expanded tobacco prevention and cessation resources for B/AA people who smoke could leverage federal regulatory actions to ban tobacco products targeted toward this group and decrease disparities in tobacco-related morbidity and mortality.

Interactions between COVID-19 family home disruptions and relationships predicting college students' mental health over time.

The present study tested whether family home disruptions during the COVID-19 pandemic in the Spring 2020 (Time 1; T1) informed mental health (i.e., posttraumatic stress disorder [PTSD], depressive, and anxiety symptoms) 7 months later in Fall 2020 at T2 and whether family relationship quality moderated relations. Multigroup path analysis models were used to test whether there were significant differences in relations by emerging adults' ethnic-racial backgrounds. Participants were 811 Black, Asian American, Latine, and White emerging adult college students (Mage = 19.95, SD = .33), and the majority (79.6%) who reported their gender identified as cisgender women. Results indicated that across all individuals, T1 family relationship quality moderated relations between T1 family home disruptions and T2 anxiety and depressive symptoms. At lower levels of T1 family relationship quality, family home disruptions predicted greater T2 depressive and anxiety symptoms. At higher levels of T1 family relationship quality, these relations were not significant. Findings highlight that family relationship quality is an important protective factor for diverse emerging adult college students. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

How psychologists can help achieve equity in health care-advancing innovative partnerships and models of care delivery: Introduction to the special issue.

For as long as the United States has been a country, the distribution of good health has been unequal. In this special issue, we consider what psychology can do to understand and ameliorate these inequalities. The introduction sets the context for why psychologists are well positioned, well trained, and needed to champion health equity via innovative partnerships and models of care delivery. A guide is provided for engaging and maintaining a health equity lens in advocacy, research, education/training, and practice efforts for psychologists, and readers are invited to apply a health equity lens to reimagine their existing and forthcoming work. More broadly, the special issue brings together a collection of 14 articles across three core themes: (a) integration of care, (b) intersections between social drivers/determinants of health, and (c) intersecting social systems. The articles collectively highlight the need for new conceptual models to guide research, education, and practice, the importance of engaging in transdisciplinary partnerships, and the urgency of collaborating with community members in cross-system alliances to tackle social drivers of health, structural racism, and contextual risks, all of which are fundamental drivers of health inequity. Although psychologists are uniquely positioned to investigate causes of inequality, develop health equity interventions, and advocate for policy changes, our voice and vision have been missing from broader national dialogues around these issues. This issue is poised to provide examples of existing equity work and inspire ALL psychologists to engage for the first time or deepen existing health equity work with renewed vigor and reimagined possibilities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Do gendered racial microaggressions influence the relationship between body appreciation and Black emerging adult women's condom use behaviors?

Background: Sexual protective behaviors, such as consistent condom use and intention, are important preventative measures against the transmission of HIV/AIDS and sexually transmitted infections. Current sexual health research has yet to explore the interaction between contextual factors, such as gendered racial microaggressions, and the role of personal factors (i.e., body appreciation) on Black women's sexual risk and protective behaviors in the United States. Guided by objectification theory, we hypothesized that sexually objectifying gendered racial microaggressions moderated the body appreciation and condom use behaviors relationship. Participants: The current study consisted of 114 Black emerging adult women in the southern United States. Results: Results showed significant interactions between the frequency of sexually objectifying gendered racial microaggressions and body appreciation on consistent condom use and condom use intention. Conclusion: Overall, these findings suggested the need for sexual health researchers and interventionists to further explore the influence of gendered racial microaggressions and body appreciation on condom use behaviors.

Responses of African American Individuals Who Use Menthol Cigarettes to Potential Flavored Tobacco Bans.

INTRODUCTION: The U.S. Food and Drug Administration has proposed new product standards regarding the availability of menthol cigarettes and flavored cigars in the U.S. However, it is unclear whether limiting characterizing flavors in cigarettes and cigars as proposed, or across all tobacco products, produces differential effects on the tobacco use behaviors of African American/Black individuals who use menthol cigarettes. This study assessed whether limiting characterizing flavors in combusted products only or across all tobacco products produces differential impacts on the tobacco use behaviors of African American/Black individuals who use menthol cigarettes. METHODS: Adult African American/Black individuals who use menthol cigarettes in the U.S. were recruited through Qualtrics (n=373) and in Richmond, VA (n=206) for an online experiment from September 2021 to August 2022. Participants reported how their tobacco use behaviors would change under 3 scenarios: maintenance of the status quo, limited flavor ban (ban characterizing flavors in cigarettes and cigars), and comprehensive flavor ban (ban characterizing flavors in all tobacco products). Seemingly unrelated regressions compared differences in expected responses to policy scenarios (p<0.05). RESULTS: Both flavor ban scenarios resulted in higher quitting intentions for cigarettes and all tobacco products than the status quo (p<0.05). The comprehensive ban resulted in greater intentions to quit all tobacco products and lower intentions to switch to certain alternative products (e.g., E-cigarettes, smokeless tobacco, heated tobacco products) than the limited ban (p<0.05). CONCLUSIONS: African American/Black individuals who use menthol cigarettes appear more likely to quit smoking if characterizing flavors in combusted products (e.g., menthol cigarettes) are banned, regardless of if characterizing flavors are available in noncombusted alternative tobacco products.

Sex differences in how ethnic-racial identity informs first coital affect and virginity beliefs among Black college students.

Objective: The present study examined whether ethnic-racial identity (ERI) exploration, resolution, and affirmation informed individuals' beliefs about virginity (ie, virginity as a gift, stigma, process) and first coital affective reactions (FCAR; ie, positive and negative), and whether these relations varied by biological sex. Participants and method: The sample consisted of 184 Black college students (Mage = 19.79, SD = 2.08) enrolled in a large Southern university. Participants completed a virginity beliefs measure, first coital affective reaction measure, and an ethnic-racial identity measure. Results: Findings indicated that for Black females, greater ERI exploration was associated with decreased virginity as a gift beliefs; and ERI resolution was associated with increased virginity as a gift beliefs. Additionally, for Black males and females, ERI affirmation resulted in more positive FCAR, less negative FCAR, and less views of virginity as a stigma. Conclusion: Finding implications are presented in the context of future research.

COVID-19-Induced Inequalities and Mental Health: Testing the Moderating Roles of Self-rated Health and Race/Ethnicity.

This study examines the relationship among COVID-19-induced social, economic, and educational inequalities on mental health (i.e., anxiety and depression). This study also examines if levels of self-rated health (SRH) moderate the relationship (i.e., COVID-induced inequalities [CII] and mental health), as well as examines the racial/ethnic group differences among 567 young adults in the mid-Atlantic region. Using a moderation model, results indicate that CII were significantly related to depression (b = .221, t(554) = 4.59, p = .000) and anxiety (b = .140, t(555) = 3.23, p = .001). SRH and race/ethnicity also moderated both relationships. At above-average SRH (i.e., moderator), higher CII were also significantly related to lower anxiety (Asian young adults only) and lower depression (Asian and White young adults only). Overall, SRH and race/ethnicity are important factors in the mental health impact of COVID-19 on young adults.

Mexican-origin 5-year-old children's ethnic-racial identity centrality and attitudes predicting social functioning.

OBJECTIVE: Early childhood is an important developmental period to focus on the outcomes associated with ethnic-racial identity (ERI) given that children notice racial differences, are processing information about ethnicity and race, and have race-related experiences. The present study tested whether three components of ERI (i.e., positive attitudes, negative attitudes, and centrality) predicted children's social functioning (i.e., interactive, disruptive, and disconnected play with peers; externalizing behaviors; and observed frustration and cooperation with an adult). Child sex was also tested as a moderator. METHOD: The present study included 182 5-year-old Mexican-origin children (57% male) of mothers who entered parenthood during adolescence (M = 21.95, SD = 1.00). RESULTS: Children's positive ethnic-racial attitudes were associated with greater social functioning (i.e., greater interactive play and less externalizing behaviors) among boys and girls, and less frustration among boys. Negative ethnic-racial attitudes predicted maladaptive social functioning (i.e., greater disruptive play) among boys and girls and more disconnected play among girls. Contrary to expectations, ethnic-racial centrality predicted boys' and girls' maladaptive social functioning (i.e., greater disruptive and disconnected play). CONCLUSIONS: Findings highlight the importance of fostering children's positive ethnic-racial attitudes and helping them discuss and cope with negative ethnic-racial attitudes to promote more adaptive social functioning. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Associations Between Experienced HIV Stigma, Resulting Consequences, and the HIV Care Continuum: Moderating Effects of Two Resilience Characteristics Among Persons Living with HIV (PLWH) in Louisiana.

INTRODUCTION: HIV-related stigma continues to serve as a major barrier to HIV care. HIV stigma reduction interventions are urgently needed to promote and protect the health of persons living with HIV (PLWH). Resilience has been identified as a potential leverage to mitigate the impact of HIV-related stigma among PLWH. METHODS: We examined whether two resilience measures (i.e., social support and resilience assets and resources [RAR]) moderated the relationship between experienced HIV stigma and the HIV care continuum as well as how they moderated the relationship between the consequences of experienced HIV stigma (CES) and the HIV care continuum among 300 PLWH in Louisiana. Separate bootstrapping analyses were conducted to test for evidence of moderated moderation. RESULTS: Most participants were Black (79%) and had been living with HIV for 10 years or more. A relatively high sample of men who have sex with men (MSM) were enrolled (37%). The most common CES were depression (67%). The most common manifestation of experienced HIV stigma was being gossiped about (53%). Participants reported moderate levels of social support. In terms of RAR, most participants (71%) reported that they knew of groups that could support them in responding to experienced HIV stigma. After adjusting for potential covariates, social support and RAR both significantly moderated the relationship between experienced HIV stigma and length of time since their last HIV care visit, B(SE) = .003(.001), p = .03. At high levels of RAR and high levels of social support, those with higher levels of experienced HIV stigma reported a longer length of time since their last HIV care visit than those who reported lower levels of experienced HIV stigma (B(SE) = .17(.04), p < .001). RAR moderated the relationship between social support and HIV care, B(SE) = .01(.004), p < .001. Those who experienced greater CES reported a longer length of time since their last doctor's visit B(SE) = .04(.02), p < .05. Experienced HIV stigma was not significantly associated with viral load results. However, social support significantly moderated the relationship between experienced stigma and viral load results. At higher levels of social support, those who experienced lower levels of stigma were more likely to report an undetectable viral load than those who had higher levels of stigma, B(SE) = - .13(.03), p < .001. Finally, both RAR and social support moderated the relationship between CES and viral load results. Those who reported higher levels of RAR B(SE) = - .07(.02), p < .001, and social support, B(SE) = - .02(.01), p < .05, also reported having an undetectable viral load at most recent HIV care visit. CES was not significantly related to reporting an undetectable viral load (p = .61). CONCLUSIONS: Enrolled PLWH already have some level of resilience which plays an important protective role within the context of the HIV care continuum up to a certain extent. Interventions to enhance the RAR and social support components may be useful especially among MSM and persons who have been living with HIV for a shorter period of time.

What influences demand for cigars among African American adult cigar smokers? Results from a hypothetical purchase task.

African Americans (AA) have historically been targeted by the tobacco industry and have the highest rates of current cigar use among racial/ethnic groups in the U.S. Yet, there is limited evidence on other factors influencing cigar use. Amongst a sample of 78 AA current cigar (any type) smokers, log-linear regression models examined correlates of cigar demand obtained from a validated behavioral economic purchase task. Mean intensity, or cigar demand when free, was 6.68 cigars (standard deviation [SD]: 8.17), while mean breakpoint, or the highest price a participant was willing to pay, was $4.62 (SD: 3.88). Mean maximum daily expenditure, Omax was $15.20 (SD: 25.73) and Pmax, the price at Omax was $5.25 (SD: 3.95). Participants aged 21 to 30 years compared to those aged 18 to 20 years, those with higher levels of dependence, and females compared to males, had a significantly higher intensity. Participants with cannabis use above the sample median in the last 30 days (4 + days) had significantly higher intensity and Omax than those below the median. Further, participants with a high school education or more had a significantly lower intensity, breakpoint, and Omax than those with less than high school education. Individuals with income below the federal poverty line (FPL) also had a significantly lower breakpoint and Omax than those above. Finally, tobacco harm perceptions were inversely associated with Pmax. Stricter policies on cigar products, such as higher taxes and product-specific harm messaging, may have an immediate and sustained impact on health disparities related to cigar use. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Towards a better understanding of abortion misinformation in the USA: a review of the literature.

Roughly 20% of women in the USA will seek an abortion during their lifetimes. As abortion is a medical procedure, individuals seeking abortion services must have access to accurate medical information. Inaccurate information about abortion, known as abortion misinformation, adversely affects knowledge about abortion, and may impair informed decision-making. Abortion misinformation has received limited attention in psychological and health research. This review summarises current findings on abortion misinformation from studies of adults in the USA, examines which forms of misinformation are most common, and assesses prominent sources of abortion misinformation. A narrative, integrative approach was adopted focussing on nine articles. Findings suggest that first, inaccurate beliefs about abortion exist among many samples of US adults, including inaccurate connections between abortion and breast cancer, infertility and negative mental health outcomes. Second, abortion misinformation comes from a variety of informational sources, which may render efforts to prevent it challenging. Summarising and extending knowledge of abortion misinformation may be useful first steps to better understanding this phenomenon and may ultimately aid in reduction of abortion misinformation among individuals living in the USA.

Associations Among Behavioral Risk, Sociodemographic Identifiers, and Sexually Transmitted Infections in Male and Female Army Enlisted Personnel.

INTRODUCTION: Rates of sexually transmitted infections (STIs) are higher among U.S. military personnel than their civilian counterparts. Yet there is a paucity of military-specific research that has utilized theoretical frameworks to describe the relative influence of the multiple and interrelated risk factors associated with STIs in this population of young, healthy men and women. The aim of this study was to examine the relative influence of Information, Motivation, and Behavioral Skills Model (IMB) factors known to be associated with condom use and STI diagnosis, as well as examine gender differences among a cohort of young, active duty enlistees who are in the very early stages of their military careers. MATERIALS AND METHODS: Data were collected in 2011 to 2013 through self-administered questionnaires and laboratory-confirmed tests of STIs. Logistic regression analyses were used to assess IMB constructs, behavioral risk variables, and sociodemographic factors associated with STI diagnosis and condom use separately among female and male military personnel. RESULTS: STIs among males were significantly associated with nonwhite race, lower STI behavioral intentions and STI behavioral skills, and engaging in sex after drinking alcohol. Further, males who reported more positive attitudes toward using condoms, higher confidence in preventing drinking, higher alcohol prevention norms among peers, a lower frequency of drinking alcohol before engaging in sexual intercourse, more sexual partners, and higher STI behavioral intentions were significantly more likely to report using condoms consistently during sexual encounters. Among female participants, a history of STIs was significantly associated with higher numbers of reported sexual partners and greater alcohol prevention efficacy while lifetime consistent condom use was significantly associated only with stronger intentions to avoid behaviors that might result in STI acquisition. CONCLUSION: Our findings support the need for development of STI prevention strategies that include education and skills-building approaches to reduce alcohol misuse among enlisted military personnel, and especially male personnel. Such programs should include factors that uniquely influence the experiences of males and females in the military context.

The effect of affective versus cognitive persuasive messages on African American women's attitudes toward condom use.

OBJECTIVE: Health decision making models propose that affective associations at both the implicit and explicit level and cognitive beliefs influence health behaviours. The current studies investigated whether affective or cognitive persuasive messages would lead to more positive implicit and explicit condom use attitudes and higher intentions among African American college women. DESIGN: Participants (Study 1 N = 109; Study 2 N = 112) explicit attitudes were assess prior to watching a short video that contained either affective (e.g., safe sex is pleasurable) or cognitive messages (e.g., latex condoms are effective in preventing HIV) in favour of condom use. MAIN OUTCOME MEASURES: Following the video, participants completed the Affect Misattribution Procedure (AMP), a measure of implicit attitudes, explicit measures of condom use attitudes that assessed attitudes at the overall and component level, intentions to use condoms, and interest in receiving free sample of condoms. RESULTS: Participants in the affective message condition reported more positive condom use attitudes on both the implicit and explicit measure, higher intentions to use condoms, and more interest in receiving free condoms than those in the cognitive message condition. CONCLUSION: These results suggest that affective messages may be more effective in changing condom use attitudes, which can be used in interventions to promote protective condom use behaviours.

HIV Testing Behaviors among Black Rural Women: The Moderating Role of Conspiracy Beliefs and Partner Status Disclosure.

Objective: This study investigated whether HIV testing attitudes, HIV conspiracy beliefs, and reported sexual partner disclosure of HIV/STI status related to one-month self-report HIV testing outcomes following a brief intervention among Black women aged 18-25 years residing in rural Mississippi. Participants: Black women (N=119; M age=19.90, SD=1.81) recruited in rural Mississippi completed an online assessment before a brief HIV prevention intervention and a one month follow-up assessment during January to November 2016. Main Outcome Measures: Self-reported HIV testing 30-days following the intervention, partner HIV/STI status disclosure, beliefs in HIV conspiracy theory, and HIV testing attitudes in pre- and post-intervention assessments. Bivariate and multivariate analyses tested associations with HIV testing behaviors following the intervention. Results: Moderated moderation was used to examine whether HIV conspiracy beliefs and partner disclosure status both moderated the relationship between pre-intervention attitudes toward HIV testing and HIV testing at 1-month follow-up. It was found that both HIV conspiracy beliefs and partner disclosure moderated the relationship between attitudes and HIV testing at one-month follow-up. When partner disclosure was low, women with more negative attitudes toward testing and higher conspiracy beliefs were less likely to get tested than those with negative attitudes and lower conspiracy beliefs; conspiracy beliefs did not relate to testing outcomes when testing attitudes were positive. Conclusion: Findings suggest that interventions may benefit from accounting for conspiracy beliefs and the dyadic status disclosure when encouraging young rural women to test for HIV.

An Exploratory Study of Resilience, HIV-Related Stigma, and HIV Care Outcomes Among Men who have Sex with Men (MSM) Living with HIV in Louisiana.

The various forms of HIV-related stigma continue to serve as major barriers to HIV care and treatment among men who have sex with men (MSM). The study of resilience within the context of HIV-related stigma among MSM living with HIV represents a promising area of research to inform the development of future HIV interventions for this population. We examined resilience within the context of HIV related stigma among MSM living with HIV in Louisiana with a particular interest in how resilience may be more relevant for Black MSM. We utilized Pearson's correlations and layered chi-square non-parametric tests to examine associations and racial differences in resilience, four HIV-related stigma measures/consequences (i.e., anticipated, internalized, enacted, and consequences of enacted HIV stigma), and HIV care outcomes (i.e., length of time since last HIV care visit, time since last HIV lab result, most recent HIV viral load result) among 110 MSM living with HIV in Louisiana who participated in the Louisiana HIV Stigma Index Project. The majority of MSM participants were Black (75%), lived in New Orleans (52%), and reported limited education (52%) and income (76%). MSM who reported higher levels of enacted HIV stigma, consequences of enacted HIV stigma, and internalized HIV stigma reported poorer HIV care outcomes. Both internalized and anticipated HIV stigma significantly negatively impacted Black MSM perceptions of their overall health compared with White MSM. Compared with White MSM, Black MSM who reported greater consequences of enacted HIV stigma had poorer HIV care outcomes. Resilience was associated with positive HIV care outcomes for both Black and White MSM. However, having higher levels of resilience may have been more protective for Black MSM such that higher levels of resilience were associated with less time since last HIV care visit for Black MSM than for White MSM. The current study provides preliminary information on the potential positive relationship between resilience and HIV care outcomes among MSM, particularly Black MSM. However, these findings need to be confirmed among a more representative sample of Black and White MSM in Louisiana.

Loving myself through thick and thin: Appearance contingent self-worth, gendered racial microaggressions and African American women's body appreciation.

Contrary to previous literature, recent studies have indicated that African American women are reporting similar rates of body dissatisfaction as their European American counterparts. Yet, little is known about contextual factors, such as gendered racial microaggressions and their association with body appreciation, and whether appearance contingent self-worth accounts for this relationship. Consistent with intersectionality theory, this study examined appearance-contingent self-worth as a mediator between stress related to experiencing sexually objectifying gendered racial microaggressions and body appreciation. African American emerging adult women (N = 143), predominately from the Southern United States, completed a self-report measure of gendered racial microaggressions, appearance contingent self-worth, and body appreciation. Results demonstrated that appearance contingent self-worth, at least in part, mediated the relationship between stress related to gendered racial microaggressions and African American women's appreciation for their bodies. It is imperative future body image interventions aimed at African American emerging adult women address factors, such as appearance contingent self-worth and gendered racial microaggressions, in their efforts improve body appreciation.

The Relationship Between Body Image Perceptions and Condom Use Outcomes in a Sample of South African Emerging Adults.

HIV continues to be a health priority in South Africa. Consistent condom use helps prevent HIV, yet less than half of South African emerging adults use condoms consistently. Cultural beliefs about illnesses (e.g., being thin is perceived to be a sign of HIV infection) suggest that body image perceptions may play a role in emerging adults' condom use outcomes. We explored the relationships between body image perceptions (i.e., body dissatisfaction, body consciousness) and condom use outcomes (e.g., attitudes, negotiation efficacy, past use) in a sample of South African emerging adults. Participants (n = 379) recruited from university residences completed an anonymous survey. Participants' mean age was 21.79 years, 54.6% were female, 96.1% identified as Black African, and 73.5% reported primarily speaking IsiZulu. For women, the relationship between body dissatisfaction and condom negotiation efficacy was mediated by body consciousness and condom use attitudes after controlling for BMI, relationship status, and mental health symptoms. Further, the relationship between body dissatisfaction and past condom use was mediated by body consciousness. These results were not significant for men. Findings from this study suggest that integrating messages about body image perceptions into HIV prevention efforts targeting South African emerging adult women may be warranted.

HIV conspiracy theory beliefs mediates the connection between HIV testing attitudes and HIV prevention self-efficacy.

Objective: High rates of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) can be found in states in both the Appalachian and Southeastern regions of the United States. As infection rates increase, it is imperative to understand factors that improve HIV prevention. The current work explored whether HIV conspiracy beliefs influences the link between HIV testing attitudes and perceived prevention ability. Participants: Four samples were collected during Fall 2013 (N = 373), Spring 2014 (N = 231), Fall 2014 (N = 345), and Spring 2015 (N = 369) at a rural, Southeastern, Appalachian university. Methods: Participants in all samples completed an online survey. Results: Four studies showed that HIV conspiracy theory beliefs mediated the relationship between HIV testing attitudes and HIV prevention self-efficacy. Conclusions: HIV conspiracy theory beliefs at least partially explain the connection between testing attitudes and HIV prevention self-efficacy. Results have implications for the role of HIV testing attitudes, beliefs, and self-efficacy.

Perceptions of Risks and Benefits Among Nonprescription Stimulant Consumers, Diverters, and Non-Users.

BACKGROUND: Few studies have examined perceptions of legal and health risks along with the perceived benefits of nonprescription stimulant (NPS) use in college students (e.g., using stimulants such as Ritalin, Vvyanse, Concerta, or Adderall without a prescription). OBJECTIVE: This study sought to better understand how college students perceived legal and health risks, as well as motivations associated with NPS use. The perceived risks and benefits were examined between those involved and those uninvolved. METHOD: The sample comprised 988 undergraduates at a southeastern university. Of the participants, 65.3% (645) were females, 69.1% (682) were freshmen, and 76.5% (756) were Caucasian. Participants from a convenience sample of general psychology students (enrolled August to December 2013) completed an on-line survey regarding behaviors and beliefs about the risks/benefits and motivations related to NPS use. Non-parametric Kruskal-Wallis analyses were conducted to examine perceptions of risks and motivations between those involved and those uninvolved in NPS use. RESULTS: In the sample, 8.1% (n = 80) had a current prescription, with 30 individuals classified as diverters. Of participants, 23.1% (n = 228) reported that they were consumers of NPS medication. Results of the Kruskal-Wallis analyses showed that, compared with uninvolved students, those involved with stimulant medications perceived significantly greater cognitive benefits but less legal and health risks. Conclusions/Importance: College students involved in the misuse (using a stimulant without a prescription or diverting stimulant medication to others) of NPS medications may underestimate associated risks and overestimate benefits.