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1.  THE LANGUAGE OF BLACK GAY MEN’S SEXUAL BEHAVIOR: IMPLICATIONS FOR AIDS RISK REDUCTION 
Journal of sex research  1992;29(3):425-434.
The development of appropriate AIDS risk reduction interventions targeted at African-American gay men could be aided by an awareness of their terminology for specific sexual behaviors and types of sexual encounters. This paper explores similarities and differences between the HIV-related sexual language of Black and White gay men. While much of the vernacular is shared, differences in some terms and greater or lesser emphasis on others are apparent.
doi:10.1080/00224499209551657
PMCID: PMC4222679  PMID: 25382870
Black gay men; AIDS; sexual language
2.  Prevalence of Mental Disorders, Psychological Distress, and Mental Health Services Use Among Lesbian, Gay, and Bisexual Adults in the United States 
Recent estimates of mental health morbidity among adults reporting same-gender sexual partners suggest that lesbians, gay men, and bisexual individuals may experience excess risk for some mental disorders as compared with heterosexual individuals. However, sexual orientation has not been measured directly. Using data from a nationally representative survey of 2,917 midlife adults, the authors examined possible sexual orientation-related differences in morbidity, distress, and mental health services use. Results indicate that gay–bisexual men evidenced higher prevalence of depression, panic attacks, and psychological distress than heterosexual men. Lesbian–bisexual women showed greater prevalence of generalized anxiety disorder than heterosexual women. Services use was more frequent among those of minority sexual orientation. Findings support the existence of sexual orientation differences in patterns of morbidity and treatment use.
PMCID: PMC4197971  PMID: 12602425
3.  Estimates of Alcohol Use and Clinical Treatment Needs Among Homosexually Active Men and Women in the U.S. Population 
Concerns about dysfunctional alcohol use among lesbians and gay men are longstanding. The authors examined alcohol use patterns and treatment utilization among adults interviewed in the 1996 National Household Survey on Drug Abuse. Sexually active respondents were classified into 2 groups: those with at least 1 same-gender sexual partner (n = 194) in the year prior to interview and those with only opposite-gender sexual partners (n = 9,714). The authors compared these 2 groups separately by gender. For men, normative alcohol use patterns or morbidity did not differ significantly between the 2 groups. However, homosexually active women reported using alcohol more frequently and in greater amounts and experienced greater alcohol-related morbidity than exclusively heterosexually active women. Findings suggest higher risk for alcohol-related problems among lesbians as compared with other women, perhaps because of a more common pattern of moderate alcohol consumption.
PMCID: PMC4197972  PMID: 11142540
4.  Optimal Scaling of HIV-Related Sexual Risk Behaviors in Ethnically Diverse Homosexually Active Men 
As HIV-related behavioral research moves increasingly in the direction of seeking to determine predictors of high-risk sexual behavior, more efficient methods of specifying patterns are needed. Two statistical techniques, homogeneity analysis and latent class analysis, useful in scaling binary multivariate data profiles are presented. Both were used to analyze reported sexual behavior patterns in two samples of homosexually active men, one sample of 343 primarily White gay men attending an HIV workshop and one sample of 837 African American gay men recruited nationally. Results support the existence of a single, nonlinear, latent dimension underlying male homosexual behaviors consistent with HIV-related risk taking. Both statistical methods provide an efficient means to optimally scale sexual behavior patterns, a critical outcome variable in HIV-related research.
PMCID: PMC4196998  PMID: 7751488
5.  Issues in the Perception of AIDS Risk and Risk Reduction Activities by Black and Hispanic/Latina Women 
The American psychologist  1988;43(11):949-957.
Although to date most cases of Acquired Immunodeficiency Syndrome (AIDS) have occurred among men, AIDS poses a serious threat for Black and Latina women, particularly for those who are poor and live in geographic areas of higher AIDS incidence. Yet many may not perceive themselves to be at risk from what has generally been portrayed as a “White gay disease.” This article examines patterns of AIDS infection in women and factors associated with risk perception and behavior change. In doing so, the influence of ethnic minority culture on the behavior of individual women is explored.
PMCID: PMC4196373  PMID: 3214007
8.  Is there a legacy of the U.S. Public Health Syphilis Study at Tuskegee in HIV/AIDS-related beliefs among heterosexual African-Americans and Latinos? 
Ethics & behavior  2012;22(6):461-471.
Knowledge of the US Public Health Syphilis Study at Tuskegee is sometime cited as a principal reason for the relatively low participation rates seen among racial/ethnic minorities, particularly African Americans, in biomedical research. However, only a few studies have actually explored this possibility. We use data from a random digit dial telephone survey of 510 African-Americans and 253 Latinos, age 18 to 45 years, to investigate associations between knowledge of the USPHS Syphilis Study at Tuskegee and endorsement of HIV/AIDS conspiracy theories. All respondents were drawn from an area of low-income, predominantly race-segregated inner city households in Los Angeles. Results indicate that African Americans were significantly more likely than Latinos to endorse HIV/AIDS conspiracy theories. Further, African Americans were more aware of the USPHS Syphilis Study at Tuskegee (SST). Nevertheless, 72% of African Americans and 94% of Latinos reported that they have never heard of the Syphilis Study at Tuskegee. Further, while awareness of the Syphilis Study at Tuskegee was a significant predictor of endorsing HIV/AIDS conspiracy theories, results suggest that other factors may be more important in accounting for low biomedical and behavioral study participation rates.
doi:10.1080/10508422.2012.730805
PMCID: PMC3539790  PMID: 23308036
9.  The Legacy of the U. S. Public Health Services Study of Untreated Syphilis in African American Men at Tuskegee on the Affordable Care Act and Health Care Reform Fifteen Years After President Clinton’s Apology 
Ethics & behavior  2012;22(6):411-418.
This special issue addresses the legacy of the United States Public Health Service Syphilis Study on health reform, particularly the Affordable Care Act (ACA). The 12 manuscripts cover the history and current practices of ethical abuses affecting American Indians, Latinos, Asian Americans and African Americans in the United States and in one case, internationally. Commentaries and essays include the voice of a daughter of one of the study participants in which we learn of the stigma and maltreatment some of the families experienced and how the study has impacted generations within the families. Consideration is given in one essay to utilizing narrative storytelling with the families to help promote healing.
This article provides the reader a roadmap to the themes that emerged from the collection of articles. These themes include population versus individual consent issues, need for better government oversight in research and health care, the need for overhauling our bioethics training to develop a population level, culturally driven approach to research bioethics. The articles challenge and inform us that some of our assumptions about how the consent process best works to protect racial/ethnic minorities may be merely assumptions and not proven facts. Articles challenge the belief that low participation rates seen in biomedical studies have resulted from the legacy of the USPHS Syphilis Study rather than a confluence of factors rooted in racism, bias and negative treatment. Articles in this special issue challenge the “cultural paranoia” of mistrust and provide insights into how the distrust may serve to lengthen rather than shorten the lives of racial/ethnic minorities who have been used as guinea pigs on more than one occasion. We hope that the guidance offered on the importance of developing a new framework to bioethics can be integrated into the foundation of health care reform.
doi:10.1080/10508422.2012.730808
PMCID: PMC3636721  PMID: 23630410
Tuskegee; research bioethics; survivors
10.  Using the Science of Psychology to Target Perpetrators of Racism and Race-Based Discrimination For Intervention Efforts: Preventing Another Trayvon Martin Tragedy 
Psychological science offers a variety of methods to both understand and intervene when acts of potential racial or ethnic racism, bias or prejudice occur. The Trayvon Martin killing is a reminder of how vulnerable African American men and boys, especially young African American men, are to becoming victims of social inequities in our society. We examine several historical events of racial bias (the Los Angeles civil disturbance after the Rodney King verdict, the federal government’s launch of a “War on Drugs” and the killing of Trayvon Martin) to illustrate the ways in which behaviors of racism and race-based discrimination can be viewed from a psychological science lens in the hopes of eliminating and preventing these behaviors. If society is to help end the genocide of African American men and boys then we must broaden our focus from simply understanding instances of victimization to a larger concern with determining how policies, laws, and societal norms serve as the foundation for maintaining implicit biases that are at the root of race-based discrimination, prejudice, bias and inequity. In our call to action, we highlight the contributions that psychologists, particularly racial and ethnic minority professionals, can make to reduce the negative impact of racial and ethnic bias through their volunteer/pro bono clinical efforts.
PMCID: PMC3718570  PMID: 23885310
prejudice; discrimination; bias; African Americans; men; Rodney King; War on Drugs
11.  Perceived Race-Based Discrimination, Employment Status, and Job Stress in a National Sample of Black Women: Implications for Health Outcomes 
Previous research has not systematically examined the relationship of perceived race-based discriminations to labor force participation or job related stresses–problems experienced by Black women. The present study investigated the relative contributions of perceived race-based discriminations and sociodemographic characteristics to employment status and job stress in a national probability sample (the National Survey of Black Americans; J. S. Jackson, 1991) of Black women in the United States. Logit and polychotomous logistic regression analyses revealed that Black women’s current employment status was best explained by sociodemographic measures. In contrast, the combination of perceived discrimination and sociodemographics differentially affects patterns of employment status and perceived job stress in the work environment of Black women. Implications of these findings for the health of African American women are discussed.
PMCID: PMC3681822  PMID: 9547054
12.  Engaging Student Health Organizations in Reducing Health Disparities in Underserved Communities through Volunteerism: Developing a Student Health Corps 
One underutilized method for reducing health disparities and training culturally competent health care workers is the engagement of undergraduate student health organizations in conducting health screenings, promotion, and health education outreach activities in in underserved racial/ethnic communities. We conducted a needs assessment of 14 predominantly racial/ethnic minority undergraduate student-run health organizations. The 14 organizations annually served approximately 12,425 people (67% Hispanic, 25% African American, 6.33% Asian Pacific Islander), predominantly at health fairs within Los Angeles County (averaging 138 attendees). Student organizations provided screenings on general health conditions and diseases, with less emphasis on behavioral risk factors (e.g., drinking, smoking). Organizations indicated a need for increased and affordable trainings in preventive health screenings and help in understanding target populations’ needs. Universities are in an excellent position to train, supervise, and organize volunteer health corps in order to engage students in reducing health disparities and to train culturally competent health care providers.
doi:10.1353/hpu.0.0190
PMCID: PMC3669463  PMID: 19648716
health disparities; civic engagement; health fairs; medical education; screenings; racial/ethnic minorities; prevention; volunteerism; health corps
13.  Influence of American acculturation on cigarette smoking behaviors among Asian American subpopulations in California 
Using combined data from the population-based 2001 and 2003 California Health Interview Surveys, we examined ethnic and gender-specific smoking behaviors and the effect of three acculturation indicators on cigarette smoking behavior and quitting status among 8,192 Chinese, Filipino, South Asian, Japanese, Korean, and Vietnamese American men and women. After adjustment for potential confounders, current smoking prevalence was higher and the quit rate was lower for Korean, Filipino, and Vietnamese American men compared with Chinese American men. Women’s current smoking prevalence was lower than men’s in all six Asian American subgroups. South Asian and Korean American women reported lower quit rates than women from other ethnic subgroups. Asian American men who reported using only English at home had lower current smoking prevalence and higher quit rates, except for Filipino and South Asian American men. Asian American women who reported using only English at home had higher current smoking prevalence except for Japanese women. Being a second or later generation immigrant was associated with lower smoking prevalence among all Asian American subgroups of men. Less educated men and women had higher smoking prevalence and lower quit rates. In conclusion, both current smoking prevalence and quit rates vary distinctively across gender and ethnic subgroups among Asian Americans in California. Acculturation appears to increase the risk of cigarette smoking for Asian American women. Future tobacco-control programs should target at high-risk Asian American subgroups, defined by ethnicity, acculturation status, and gender.
doi:10.1080/14622200801979126
PMCID: PMC3652889  PMID: 18418780
14.  Black Women, Work, Stress, and Perceived Discrimination: The Focused Support Group Model as an Intervention for Stress Reduction 
This exploratory study examined the use of two components (small and large groups) of a community-based intervention, the Focused Support Group (FSG) model, to alleviate employment-related stressors in Black women. Participants were assigned to small groups based on occupational status. Groups met for five weekly 3-hr sessions in didactic or small- and large-group formats. Two evaluations following the didactic session and the small and large group sessions elicited information on satisfaction with each of the formats, self-reported change in stress, awareness of interpersonal and sociopolitical issues affecting Black women in the labor force, assessing support networks, and usefulness of specific discussion topics to stress reduction. Results indicated the usefulness of the small- and large-group formats in reduction of self-reported stress and increases in personal and professional sources of support. Discussions on race and sex discrimination in the workplace were effective in overall stress reduction. The study highlights labor force participation as a potential source of stress for Black women, and supports the development of culture- and gender-appropriate community interventions as viable and cost-effective methods for stress reduction.
PMCID: PMC3650252  PMID: 9225548
Black women; work; stress; discrimination
15.  Applying Social Psychological Models to Predicting HIV-Related Sexual Risk Behaviors Among African Americans 
The Journal of black psychology  1993;19(2):142-154.
Existing models of attitude-behavior relationships, including the Health Belief Model, the Theory of Reasoned Action, and the Self-Efficacy Theory, are increasingly being used by psychologists to predict human immunodeficiency virus (HIV)-related risk behaviors. The authors briefly highlight some of the difficulties that might arise in applying these models to predicting the risk behaviors of African Americans. These social psychological models tend to emphasize the importance of individualistic, direct control of behavioral choices and deemphasize factors, such as racism and poverty, particularly relevant to that segment of the African American population most at risk for HIV infection. Applications of these models without taking into account the unique issues associated with behavioral choices within the African American community may fail to capture the relevant determinants of risk behaviors.
doi:10.1177/00957984930192005
PMCID: PMC3606488  PMID: 23529205
16.  HIV Prevention Research: Are We Meeting the Needs of African American Men Who Have Sex With Men?1 
The Journal of black psychology  2004;30(1):78-105.
Two decades of HIV prevention efforts with men who have sex with men (MSM) have not eliminated the risk of new HIV infections in this vulnerable population. Indeed, current incidence rates in African American MSM are similar to those usually only seen in developing countries. A review of the existing literature suggests that the prevention research agenda for Black MSM could benefit from reframing conceptualization of risk as a function of individual properties to a broad consideration of social and interpersonal determinants. Studies that investigate dyadic and social-level influences on African American MSM’s relationships are needed. This includes research explicating the diversity existing within the categorizations of Black MSM with respect to perceived identity (gay, bisexual, “men on the down low,” “homo thugz”), constructions of masculinity, sexual scripts, sources of social support, and perceived norms and expectations. Recommendations are proposed for a research agenda focusing on linkages between interpersonal and social-structural determinants of HIV risk.
doi:10.1177/0095798403260265
PMCID: PMC2798154  PMID: 20041036
down low; MSM; African American; Black; homo thugz; HIV prevention; social determinants; inequality; mental health
17.  Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy 
Annals of epidemiology  2014;25(5):366-376.
Purpose
This article describes epidemiologic evidence concerning risk of gun violence and suicide linked to psychiatric disorders, in contrast to media-fueled public perceptions of the dangerousness of mentally ill individuals, and evaluates effectiveness of policies and laws designed to prevent firearms injury and mortality associated with serious mental illnesses and substance use disorders.
Methods
Research concerning public attitudes toward persons with mental illness is reviewed and juxtaposed with evidence from benchmark epidemiologic and clinical studies of violence and mental illness and of the accuracy of psychiatrists’ risk assessments. Selected policies and laws designed to reduce gun violence in relation to mental illness are critically evaluated; evidence-based policy recommendations are presented.
Results
Media accounts of mass shootings by disturbed individuals galvanize public attention and reinforce popular belief that mental illness often results in violence. Epidemiologic studies show that the large majority of people with serious mental illnesses are never violent. However, mental illness is strongly associated with increased risk of suicide, which accounts for over half of US firearms–related fatalities.
Conclusions
Policymaking at the interface of gun violence prevention and mental illness should be based on epidemiologic data concerning risk to improve the effectiveness, feasibility, and fairness of policy initiatives.
doi:10.1016/j.annepidem.2014.03.004
PMCID: PMC4211925  PMID: 24861430
Mental illness; Psychiatric disorder; Guns; Firearms; Violence; Suicide; Policy; Law; Stigma; Risk
18.  Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy 
Annals of epidemiology  2014;25(5):366-376.
Purpose
This article describes epidemiologic evidence concerning risk of gun violence and suicide linked to psychiatric disorders, in contrast to media-fueled public perceptions of the dangerousness of mentally ill individuals, and evaluates effectiveness of policies and laws designed to prevent firearms injury and mortality associated with serious mental illnesses and substance use disorders.
Methods
Research concerning public attitudes toward persons with mental illness is reviewed and juxtaposed with evidence from benchmark epidemiologic and clinical studies of violence and mental illness and of the accuracy of psychiatrists’ risk assessments. Selected policies and laws designed to reduce gun violence in relation to mental illness are critically evaluated; evidence-based policy recommendations are presented.
Results
Media accounts of mass shootings by disturbed individuals galvanize public attention and reinforce popular belief that mental illness often results in violence. Epidemiologic studies show that the large majority of people with serious mental illnesses are never violent. However, mental illness is strongly associated with increased risk of suicide, which accounts for over half of US firearms–related fatalities.
Conclusions
Policymaking at the interface of gun violence prevention and mental illness should be based on epidemiologic data concerning risk to improve the effectiveness, feasibility, and fairness of policy initiatives.
doi:10.1016/j.annepidem.2014.03.004
PMCID: PMC4211925  PMID: 24861430
Mental illness; Psychiatric disorder; Guns; Firearms; Violence; Suicide; Policy; Law; Stigma; Risk
20.  Mortality Risks Among Persons Reporting Same-Sex Sexual Partners: Evidence From the 2008 General Social Survey—National Death Index Data Set 
American journal of public health  2015;105(2):358-364.
Objectives
We investigated the possibility that men who have sex with men (MSM) and women who have sex with women (WSW) may be at higher risk for early mortality associated with suicide and other sexual orientation–associated health risks.
Methods
We used data from the 1988–2002 General Social Surveys, with respondents followed up for mortality status as of December 31, 2008. The surveys included 17 886 persons aged 18 years or older, who reported at least 1 lifetime sexual partner. Of these, 853 reported any same-sex partners; 17 033 reported only different-sex partners. Using gender-stratified analyses, we compared these 2 groups for all-cause mortality and HIV-, suicide-, and breast cancer–related mortality.
Results
The WSW evidenced greater risk for suicide mortality than presumptively heterosexual women, but there was no evidence of similar sexual orientation–associated risk among men. All-cause mortality did not appear to differ by sexual orientation among either women or men. HIV-related deaths were not elevated among MSM or breast cancer deaths among WSW.
Conclusions
The elevated suicide mortality risk observed among WSW partially confirms public health concerns that sexual minorities experience greater burden from suicide-related mortality.
doi:10.2105/AJPH.2014.301974
PMCID: PMC4289448  PMID: 25033136
22.  Women and AIDS-Related Concerns 
The American psychologist  1989;44(3):529-535.
Acquired Immunodeficiency Syndrome (AIDS) has important implications for the practice of psychology. As the epidemic continues, the role of behavior change and psychosocial factors in the spread and transmission of Human Immunodeficiency Virus (HIV) infections assumes increasing significance. Psychologists, as behavior change experts, have a special and challenging role to play in educating the public, particularly women, about AIDS. This article examines AIDS- and HIV-related concerns in women with a focus on the personal dilemmas for the practicing psychologist, problems in health behavior advocacy, and methods and pitfalls in modifying sexual behaviors.
PMCID: PMC4197969  PMID: 2930055
23.  Sex, lies, and HIV. 
The New England journal of medicine  1990;322(11):774-775.
doi:10.1056/NEJM199003153221111
PMCID: PMC4194074  PMID: 2308606
25.  Reports of parental maltreatment during childhood in a United States population-based survey of homosexual, bisexual, and heterosexual adults☆ 
Child abuse & neglect  2002;26(11):1165-1178.
Objective
The study objective was to determine the nature and prevalence of childhood maltreatment experiences among lesbian, gay, and bisexual adults and to compare findings to those obtained from similar heterosexual adults.
Method
Data from the National Survey of Midlife Development in the United States (MIDUS), which measured both childhood experiences with parental emotional and physical maltreatment and adult sexual orientation, were used to compare childhood maltreatment experiences of 2917 heterosexual, homosexual, and bisexual individuals, age 25–74 years, separately by gender.
Results
Homosexual/bisexual men reported higher rates than heterosexual men of childhood emotional and any physical maltreatment (including major physical maltreatment) by their mother/maternal guardian and major physical maltreatment by their father/paternal guardian. In contrast, homosexual/bisexual women, as compared to heterosexual women, reported higher rates of major physical maltreatment by both their mother/maternal guardian and their father/paternal guardian. Differences among individuals with differing sexual orientations were most pronounced for the more extreme forms of physical maltreatment.
Conclusions
Adult minority sexual orientation is a risk indicator for positive histories of experiencing parental maltreatment during childhood. While the reasons for this are beyond the scope of the current study, previous research suggests that childhood individual differences, including possibly gender atypicality, may be a causal factor.
PMCID: PMC4194076  PMID: 12398854
Child maltreatment; Child abuse; Homosexuality

Results 1-25 (58)