The physician-patient relationship is important to the successful delivery of health care. Health locus of control (HLOC) of the patient, the extent to which individuals attribute their health to their own actions or to external agents, may affect the patient-provider relationship. This study examined the influences of HIV and HLOC on trust in physician among a population of predominantly minority women and their family members. Powerful others HLOC demonstrated a positive relationship with trust in physician and chance HLOC had a negative relationship with trust in physician. HIV moderated both of these relationships.

This study examined the relationship between self-reported frequency of condom use (by self or partner during the past 6 months and lifetime), locus of control, self-efficacy, and future time orientation among African American college students who were single and sexually active during the past year. Data were collected from 106 undergraduate students at a southeastern university. The sample included both men (32.1%) and women (67.9%). The mean age of the sample was 21.1 years. Locus of control did not predict condom use. Greater probability of condom use was related to higher self-efficacy and future time orientation scores. Furthermore, women with stronger future orientations exhibited more frequent current and past use of condoms in their sexual activities than males. The implications of these findings for AIDS prevention education programs are discussed.

BACKGROUND-Substance abuse in women with HIV/AIDS overshadows other priorities, including health care. Substance abuse may cause women to avoid health care systems and not adhere to their medication regimen.METHODS-A randomized controlled trial tested the efficacy of Structural Ecosystems Therapy (SET) relative to a psychoeducational health group (HG) in 126 HIV+ women in recovery. SET, a 4-month intervention, focused on building family support for relapse prevention and HIV medication adherence. Over 12-month follow-up, women were assessed for drug use and medication adherence every 2-months; CD4 T-cell count and HIV viral load were assessed every 4-months.RESULTS-Levels of drug use did not differ by condition. There was a significant difference in curvature of the rates of change in drug use with SET increasing and then decreasing and HG decreasing and then increasing. Women in SET were more likely to increase substance abuse services in response to relapse and separate from drug using household members than were women in HG. These two changes explained the decline in drug use observed within SET between 6 and 12 months. SET showed declines in medication adherence but increases in CD4 T-cell count relative to HG. The Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. increase in CD4 T-cell count in SET was related to increasing proportions of women in SET taking antiretroviral medications. NIH Public Access CONCLUSION-The results of the trial were mixed. Women in SET did not show better drug use or medication adherence outcomes, but did show improvement in CD4 T-cell count and theoretical mechanisms of action on drug relapse.

This report examines the effect of Structural Ecosystems Therapy (SET) for (n=143) HIV+ African American women on rate of relapse to substance use relative to both a person-centered approach (PCA) to therapy and a community control (CC) group. A prior report has shown SET to decrease psychological distress and family hassles relative to these two comparison groups. In new analyses, SET and CC had a significant protective effect against relapse as compared to PCA. There is evidence that SET’s protective effect on relapse was related to reductions in family hassles, whereas there was not a direct impact of change in psychological distress on rates of relapse. Lower retention in PCA, perhaps caused by the lack of a directive component to PCA may have put these women at greater risk for relapse. Whereas SET did not specifically address substance abuse, SET indirectly protected at-risk women from relapse through reductions in family hassles.

The results indicate that mood disorders, outpatient services, and total mental health costs are higher for females than males; however, total health care costs are higher for males than females.