Biomedical subjects

L L Otto-Salaj

Publications and source records attributed to L L Otto-Salaj.

7 recordsLinked to original sources

PubMed2001

Outcomes of a randomized small-group HIV prevention intervention trial for people with serious mental illness.

HIV prevalence is alarmingly high among persons with serious mental illness and severely mentally ill adults frequently engage in high-risk behavior practices. This study evaluated the effectiveness of a small-group HIV risk reduction intervention offered to 189 men and women in outpatient programs for severely mentally ill adults. Participants screened for HIV risk were randomly assigned to attend either a 7-session small-group cognitive-behavioral HIV risk reduction intervention or a time-matched comparison intervention and were followed at 3-month intervals for one year. Participants who attended the HIV risk reduction intervention increased their condom use, had a higher percentage of intercourse occasions protected by condoms, and held more positive attitudes toward condoms. Women showed greater response to the intervention than men. While many behavior change effects were present at 3-, 6- and 9-month followup assessments, most diminished by the 12-month followup. These results under-score the need for tailored but ongoing HIV prevention efforts integrated into community programs that serve people with serious mental illness.

Acquired Immunodeficiency Syndrome↗

PubMed2001

Cost-effectiveness of an HIV prevention intervention for mentally ill adults.

Adults with severe mental illness are at high risk for human immunodeficiency virus (HIV) infection and transmission. Small-group interventions that focus on sexual communication, condom use skills, and motivation to practice safer sex have been shown to be effective at helping mentally ill persons reduce their risk for HIV. However, the cost-effectiveness of these interventions has not been established. We evaluated the cost-effectiveness of a 9-session small-group intervention for women with mental illness recruited from community mental health clinics in Milwaukee, Wisconsin. We used standard techniques of cost-utility analysis to determine the cost per quality-adjusted life year (QALY) saved by the intervention. This analysis indicated that the intervention cost $679 per person, and over $136,000 per QALY saved. When the analysis was restricted to the subset of women who reported having engaged in vaginal or anal intercourse in the 3 months prior to the baseline assessment, the cost per QALY saved dropped to approximately $71,000. These estimates suggest that this intervention is marginally cost-effective in comparison with other health promotion interventions, especially if high-risk, sexual-active women are preferentially recruited.

Acquired Immunodeficiency Syndrome↗

PubMed2001

Influence of psychiatric diagnoses and symptoms on HIV risk behavior in adults with serious mental illness.

HIV seroprevalence among people with serious mental illness has increased substantially in recent years. Although the prevalence of HIV behavioral risk factors has been well documented, few researchers have chosen to investigate the impact that psychopathology may have on HIV risk behavior. A review of the literature on psychiatric diagnoses related to HIV sexual risk reveals that bipolar disorder and perhaps schizophrenia are related to increased HIV risk. Further, persons in whom both Axis I and Axis II disorders are diagnosed appear to be at greater HIV behavioral risk. Research on psychiatric symptoms shows that illness severity may vary in its relation to HIV risk according to the specific symptoms present and that excited and possibly positive symptoms may be predictors of HIV sexual risk behavior. However, there is a need for research to elucidate these relationships. Future efforts that will add most to the literature will include examinations of psychiatric symptoms and illness severity, adequate sample sizes, statistical tests showing prediction of HIV risk behavior rather than the correlation with it, controls for substance abuse or dependence, and comparisons of psychopathology across HIV-positive and HIV-negative persons.

Bipolar Disorder↗

PubMed2000

Bridging the gap between the science and service of HIV prevention: transferring effective research-based HIV prevention interventions to community AIDS service providers.

OBJECTIVES: AIDS service organizations (ASOs) rarely have access to the information needed to implement research-based HIV prevention interventions for their clients. We compared the effectiveness of 3 dissemination strategies for transferring HIV prevention models from the research arena to community providers of HIV prevention services. METHODS: Interviews were conducted with the directors of 74 ASOs to assess current HIV prevention services. ASOs were randomized to programs that provided (1) technical assistance manuals describing how to implement research-based HIV prevention interventions, (2) manuals plus a staff training workshop on how to conduct the implementation, or (3) manuals, the training workshop, and follow-up telephone consultation calls. Follow-up interviews determined whether the intervention model had been adopted. RESULTS: The dissemination package that provided ASOs with implementation manuals, staff training workshops, and follow-up consultation resulted in more frequent adoption and use of the research-based HIV prevention intervention for gay men, women, and other client populations. CONCLUSIONS: Strategies are needed to quickly transfer research-based HIV prevention methods to community providers of HIV prevention services. Active collaboration between researchers and service agencies results in more successful program adoption than distribution of implementation packages alone.

Diffusion of Innovation↗

PubMed1998

Patterns, predictors and gender differences in HIV risk among severely mentally ill men and women.

A number of studies have established high human immunodeficiency virus (HIV) seroprevalence among severely mentally ill men and women living in large urban areas. Much less research has characterized the patterns of risk behavior that contribute to elevated vulnerability to HIV/AIDS among the mentally ill, as well as psychological, situational, and gender-related influences on risk in this population. One-hundred thirty-four severely mentally ill men and women who reported sexual activity outside of an exclusive relationship or with high-risk partners completed an extensive measure battery concerning HIV risk. Knowledge about HIV was low and sexual risk behavior levels were high in the sample. On average, condoms were used in only 32% of intercourse occasions in the past three months, and nearly one-half of participants reported multiple sexual partners in the same period. Patterns common in the sample were sex associated with substance use; coerced sex, bartering sex for money, food, clothes, or a place to stay; and sex with injection drug user partners. Factors predictive of greater risk were being female, presently being in a relationship, perceiving oneself to be at risk, high levels of alcohol use, and weak risk reduction behavioral intentions. Mental health programs serving severely mentally ill men and women are reaching a population at elevated risk for contracting HIV infection, and can serve as a venue for targeted HIV prevention interventions.

Adult↗

PubMed1998

Implications of HIV treatment advances for behavioral research on AIDS: protease inhibitors and new challenges in HIV secondary prevention.

Protease inhibitor combination therapies can reduce HIV viral load, improve immune system functioning, and decrease mortality from AIDS. These medical developments raise a host of critical new issues for behavioral research on HIV/AIDS. This article reviews developments in HIV combination therapy regimens and behavioral factors involved in these regimens and focuses on four key behavioral research areas: (a) the development of interventions to promote treatment adherence, (b) psychological coping with HIV/AIDS in the context of new treatments for the disease, (c) the possible influence of treatment on continued risk behavior, and (d) behavioral research in HIV prevention and care policy areas. Advances in HIV medical care have created important new opportunities for health psychologists to contribute to the well-being of persons with HIV/AIDS.

Acquired Immunodeficiency Syndrome↗

PubMed1992

Laterality of hypnotic response.

In an investigation of hemispheric activity during hypnosis, a total of 1269 Ss received hypnotizability scales containing suggestions targeting the left or right side of the body. There were no consistent differences in response strength on the left compared to the right side. Nor were there differences in hypnotizability between right- and left-handed (and ambidextrous) Ss, or between Ss who sat on the left versus right side of the testing room. Definitive evidence of lateralized cerebral activity associated with hypnosis and hypnotizability can only come from direct neuropsychological, electrocortical, or brain-imaging investigations.

Female↗