The purpose of this study was to shorten an HIV stigma scale to make it less burdensome for HIV + youth without compromising psychometric properties. The shortened questionnaire showed good internal consistency and validity; suggesting that a 10 item measure of stigma has promise for assessing this important construct in HIV + youth.Stigma is a discrediting social label which changes the way the individual looks at him/her self and disqualifies them from full social acceptance 1 . HIV has a particular, insidious stigmatization since it is associated with factors which imbue judgment and criticism such as sexual behavior and substance use 2 . This "blaming the victim" increases the isolation and shame that the individual internalizes 3 which leads to fear of accessing services 4, 5 as well as psychosocial consequences. In a study in an urban clinic of adult HIV patients, HIV stigma using the Berger scale of stigma, was associated with depressive symptomatology and a lower quality of life 6 .The stigma felt by HIV+ youth and the consequences of this stigma have not been studied. The first step is to ensure adequate measurement of stigma in this population. Berger developed a 40-item measure for HIV+ adults (predominantly Caucasian and male). 7 The purpose of the present study was to reduce instrument burden by shortening the HIV Stigma Scale to 10 items and to test its psychometric properties in a sample of predominantly African American youth (16-25) with HIV. We hypothesized that the shortened measure would have good internal

This study piloted a brief individual motivational intervention targeting multiple health risk behaviors in HIV-positive youth aged 16-25. Interviews about sexual behavior and substance use and viral load testing were obtained from 51 HIV-positive youth at baseline and post intervention. Youth were randomized to receive a four-session motivational enhancement intervention (N = 25) or to a wait-list control (N = 26). Of the eligible youth approached, 88% agreed to participate, and 80% percent of participants completed at least three of four sessions. The treatment group showed significantly greater reductions in unprotected sex acts and in viral load compared with controls. Although change scores for substance use were not significantly different between the two groups, paired t tests demonstrated that reductions in alcohol use and marijuana use were significant for the treatment group at the trend level. There were no significant differences in substance use from baseline to posttest for the control group. Findings demonstrate the potential of a brief motivational enhancement intervention to improve health risk behaviors in HIV-positive youth. Larger randomized clinical trials are warranted. Resources required for retention should not be underestimated.

The purpose of this study was to describe mental health symptoms in a sample of 66 HIV-positive youth (ages 16-25) and to evaluate social support, disclosure, and physical status as predictors of symptoms. Data were collected from January 2002 to May 2003. As measured by the Brief Symptom Inventory (BSI), 50% of the youth scored above the cutoff for clinically significant mental health symptoms, thus highlighting the need for mental health services. Lower social support, higher viral load, HIV-status disclosure to acquaintances, and being gay/lesbian/bisexual (GLB) were all significantly correlated with more mental health symptoms, but disclosure to family and close friends and contact with service providers were not. Furthermore, regression analysis showed that social support, viral load, and disclosure to acquaintances predicted 32% of the variance in mental health symptoms. Being GLB was no longer significant, most likely because of shared variance with low social support. Results suggest the importance of mental health interventions, and the potential of social support interventions to improve mental health. Further research addressing the role of HIV-related stigma and homophobia is warranted.

it could greatly increase the proportion of pregnant smokers who receive an evidence-based brief intervention. IntroductionSmoking during pregnancy has long been associated with adverse fetal outcomes. For example, smoking during pregnancy has been linked to fetal growth retardation, with estimates suggesting that 20%-30% of all cases of low birth weight can be attributed to prenatal tobacco exposure (Andres & Day, 2000). Increasing evidence also suggests that prenatal exposure to tobacco is associated with a range of additional risks from sudden infant death syndrome to long-term cognitive and behavioral deficits (e.g., Ness et al., 1999;Shea & Steiner, 2008;Stroud et al., 2009).A range of intervention approaches has been found to be efficacious in promoting smoking cessation. Among these are brief intervention approaches, which were supported in the most recent Clinical Practice Guidelines on smoking cessation (Fiore et al., 2008). Brief interventions are associated with small but clear increases in smoking cessation (Heckman, Egleston, & Hofmann, 2010;Hettema & Hendricks, 2010;Lai, Cahill, Qin, & Tang, 2010), including among pregnant women (Ferreira-Borges, 2005;Melvin, Dolan-Mullen, Windsor, Whiteside, & Goldenberg, 2000;Mullen, 1999;Pbert et al., 2004). Despite its small effects, the brief nature and primary care application of brief approaches means that they can theoretically be presented to a relatively large proportion of women who smoke during pregnancy, giving it the potential for high population impact.Contingency management (CM), in contrast, consistently yields strong effects but requires more effort and resources than Abstract Introduction: Implementation of evidence-based interventions for smoking during pregnancy is challenging. We developed 2 highly replicable interventions for smoking during pregnancy: (a) a computer-delivered 5As-based brief intervention (CD-5As) and (b) a computer-assisted, simplified, and low-intensity contingency management (CM-Lite). Methods:A sample of 110 primarily Black pregnant women reporting smoking in the past week were recruited from prenatal care clinics and randomly assigned to CD-5As (n = 26), CM-Lite (n = 28), CD-5As plus CM-Lite (n = 30), or treatment as usual (n = 26). Self-report of smoking, urine cotinine, and breath CO were measured 10 weeks following randomization.Results: Participants rated both interventions highly (e.g., 87.5% of CD-5As participants reported increases in likelihood of quitting), but most CM-Lite participants did not initiate reinforcement sessions and did not show increased abstinence. CD-5As led to increased abstinence as measured by cotinine (43.5% cotinine negative vs. 17.4%; odds ratio [OR] = 10.1, p = .02) but not for CO-confirmed 7-day point prevalence (30.4% abstinent vs. 8.7%; OR = 5.7, p = .06). Collapsing across CM-Lite status, participants receiving the CD-5As intervention were more likely to talk to a doctor or nurse about their smoking (60.5% vs. 30.8%; OR = 3.0, p = .02).Conclusions: Low-intensity participant-initiated C...

The purpose of this study was to test variables consistently identified in the adult HIV literature as predictors of adherence (self-efficacy, social support, and psychological distress) in a sample of 24 HIV-positive youth (ages 16-24). Self-efficacy and psychological distress were significantly correlated with adherence but social support was not. Social support specific to taking medications was correlated with self-efficacy. In regression analysis, both self-efficacy and psychological distress were independently related to adherence and together accounted for 47% of the variance. Results suggest the potential of mental health interventions that boost self-efficacy and reduce psychological distress but require replication with larger samples.