THE INFLUENCE OF HIV RISK CO-FACTORS AND SEXUAL NETWORKS FACTORS ON HIV RISK BEHAVIORS AMONG BLACK MSM
Laurens Van Sluytman
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This project uses the theory of eco-social epidemiology to enhance the social work perspectives on social justice and person in environment to correct the tendency to focus on individual level change interventions in public health and social work in the HIV sectors. In doing so, it moves beyond a single lens exploration of risk factors to a deeper examination of the multiple relationships that exist between risk co-factors, sexual networks and high-risk behavior among Black MSM. Using secondary analysis of data collected during the quantitative phase of the CDC-funded Brothers y Hermanos (ByH) research project (2003-2006), the project explored the structural, socio-cultural, psychological, and behavioral dimensions relevant to understanding risk for transmitting or contracting HIV for 614 MSM who identified as Black among the ByH respondents, of whom 36.3% reported being negative, indeterminate or unaware of their HIV status. A quarter (24.9%) of participants were between 41-45 years of age, followed by age group 46-50 years (18.1%).63% resided in NYC for 21 years or more, with 15.3% having resided in New York for 5 years or less, and 6% residing in the region between 16 - 20 years. Path analysis was used to provide estimates of the magnitude and significance of causal connections between HIV risk cofactors sexual network factors and HIV risk behavior. The analysis found no direct or indirect interactions among HIV risk co-factors and HIV behavior risk factors (UAIr) with the specified model demonstrating poor fit (x2=187.54, df = 45, p =.000), CFI = .007, RMSEA = .072.). Additionally, the analysis found no direct or indirect interactions among HIV risk co-factors, sexual network factors and HIV behavior risk factors (x2= 191.14, df = 88, p =.000), CFI =.808, RMSEA=.044 although the model accounted for almost 81% of variance in UAIr. The findings demonstrate the need to move beyond stereotypic perceptions of Black MSM to a more dynamic appreciation of the interactive aspects of their environments. Second, the findings underscore the need for social workers to act as allies and change agents through research and problem definition. And, they reflect the need for social workers to engage in policy analysis that investigates the significance of changed policies or ineffective interventions that differentially impact poor communities in general and specific members of these communities. The interventions designed to address the disproportionate rates of sero-conversion and transmission of HIV among Black MSM must consider the complex real world phenomena that contribute to these disparities. Interventions require attention to methods and policies that are contextually driven.. Grounded in demands for social justice, it is incumbent upon social welfare to act--by organizing community and challenging existing structural and institutionalized polices. This being the case, we must conduct client assessments that surface important information concerning risks, as well as levels of functioning and interactions within the community, using tools that assist workers to identify service delivery needs over the life span, including education, histories of violence, incarceration, exposure to discrimination and substance use. Lastly, social work must begin to reconceptualize consumer participation and engagement in social work throughout their contact with consumers and engage members of all communities with whom programs are affiliated. Social workers, educators, researchers and organizations must become concerned with the past, present and future biographies of clients and their communities. Best practices must be conceptualized as launch pads to enhancing operations and require the organization to match its technology to the intersection of needs of its stakeholders and their communities.
Being With Difference: Parenting Experiences of Gay Adoptive Fathers
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Increasingly more gay men are becoming parents or desire to become parents. Families headed by openly gay fathers live in environments that are still largely homophobic and heterosexist. This study describes the challenges, opportunities, and rewards gay adoptive fathers experience at home and in their communities. In-depth phenomenological interviews were conducted with gay adoptive fathers from 20 families (18 gay couples and 2 single gay men). Fathers adopted children through both domestic and international routes. The children of the fathers ranged in age from 9 months to 22 years. Using a social constructionist lens and descriptive phenomenological analysis, themes within each interview and across interviews were identified. The men in this study became parents in a society dominated by the beliefs that all children need a female mother, gay men cannot and should not be parents, and homosexuality is morally wrong. Their parenting stories illuminate social landscapes dotted with evolving attitudes towards gay parenting, structural inequities against LGBT communities, and entrenched beliefs about gender, sexuality and family. While some fathers worked with adoption professionals who challenged these attitudes and advocated for same sex parenting, many fathers regularly encountered heteronormative biases in the adoption system. When asked what it was like to parent as gay men, fathers explained that in many respects their day to day experiences were very similar to those of heterosexual parents, and particularly to other adoptive parents. At the same time, they often faced reminders at home and in public spaces that they were not part of a heterosexual order. From sidewalk to airport, hospital to playground, classroom to café, gay fathers and their families drew attention. Fathers regularly encountered questions and comments about the nature of their family. They had to decide if and how to explain themselves or correct others' assumptions, while modeling honesty and pride about their families to their children. Research on families headed by same sex parents has largely focused on the "impacts" gay and lesbian parents have on children's social, emotional and psychological adjustment and the degree to which their families are similar to families with heterosexual parents. The stories shared in this study move beyond such questions and dive into the heart of being with difference and the meanings difference has for gay fathers, their children and those around them. The fathers provide a vivid picture of their emotional bonds with their children and the strengths and resiliencies they and their children develop living in environments that are largely homophobic and heterosexist. With the information provided by this dissertation, practitioners can challenge heteronormative biases in social work practice, education, and public policy. By revealing the insidious ways heteronormativity "shows up", the results prompt social workers to investigate their beliefs about gay male sexuality and intimacy, the primacy of the heterosexual nuclear family, and conventional notions that a child needs both a female mother and a male father. The father's experiences raise provocative practice questions about nurturing and child rearing. The stories urge practitioners to investigate complex and taken for granted notions about gender and parenthood, and help them engage more sensitively with families headed by same sex parents.
Situational Predictors of Adolescent Homicide: A Secondary Analysis
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At every age and within all racial and ethnic groups, males are more likely than females to be victims and perpetrators of serious physical violence. Sex differences in victimization and offending rates are maintained globally and historically. Research also documents the intrasexual nature of violence and indicates that outcomes from male-to-male assaultive encounters range from no injury to death. This study employed a probability sample of adjudicated violent adolescent offenders in New York State to investigate juvenile perpetrated male-to-male violence. Using a sociological framework that encompasses theories of criminal lethality and compulsory masculinity, background characteristics were assessed to delineate structural-cultural factors that dispose adolescent males to violent interaction. Crime characteristics were also examined to differentiate between assaultive encounters that end in death of the victim (i.e. homicide) and those that do not (i.e. aggravated assault). The results of this investigation confirm theoretical predictions and empirical literature regarding male honor contest violence, as well as situational factors affecting death from assault. The largest portion of these male-to-male confrontations involved Black and Latino adolescents as both victims and offenders. The vast majority of encounters were motivated by some form of "face" or respect dispute. Adolescent perpetrators generally resided in communities with very high rates of neighborhood violence, drug trafficking, and availability of guns. These youth maintained alpha male lifestyles - namely, participation in drug trade, association with violent peer groups, and experiences with guns - that increased their exposure to violence. Notwithstanding the similarity of background characteristics, homicides and aggravated assaults were statistically different with respect to several features of the immediate situational context, especially the type of weapon involved, guns to which they had access, and offenders' specific intent to do harm. Social service models and social work practice principles are discussed in relation to the findings of this study.
Accreditation's Impact on Organizational Capacity: A Data-Mining Study
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This study explores what relationship, if any, exists between accreditation and organizational capacity in nonprofit social service organizations. Organizational capacity refers to the total output or activity necessary to achieve the organization's mission; it is inclusive of eight elements, deemed by the literature, as relevant for organizations' effectiveness and sustainability. The Council on Accreditation (COA), a national accrediting body, affords organizations the opportunity to implement nationally-vetted administrative and management standards, intended to build organizational capacity. This is a practice based research (PBR) study that employs available data mined from organizations engaged in accreditation process. A developmental perspective provides insight into the capacity needs of the two hundred and sixty-five organizations in the study. The diverse characteristics of these organizations reveal significant associations with selected organizational capacity elements: mission clarity, financial management, information and technology, and performance quality improvement. This prospective study employs a routinely administered pre- test, prior to beginning the accreditation process, and post- test, after completion of accreditation milestones, to understand organizations' assessment of accreditation on their capacity. The survey data is compared to the organization's accreditation outcomes. Noteworthy findings include support for assessment as an act of capacity building. Fifty-nine percent of organizations completing the post-test indicate increased capacity as compared to nine percent that indicate no post-test change in capacity, and thirty- two percent that indicate reduced post-test capacity. Organizations in all three cohorts (increased, neutral, or reduced capacity), had good or better accreditation outcomes. However, organizations with insufficient outcomes were those seeking reaccreditation and in the cohort that assessed reduced post-test capacity. Organizations that assessed increased or no change in capacity had good to excellent outcomes as indicated by the vehicle of accreditation. Support for organizations to utilize accreditation as a vehicle to expand their capacity, has implications for funding for organizations' development. Further research can explore whether effectively managed organizations have quality service delivery systems, and positive outcomes for persons served.
THE EXPERIENCES OF INCARCERATED MOTHERS AFFECTED BY SEPARATION FROM THEIR CHILDREN: THE IMPACT OF THE ROCKEFELLER DRUG LAWS
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THE EXPERIENCES OF INCARCERATED MOTHERS AFFECTED BY SEPARATION FROM THEIR CHILDREN: THE IMPACT OF THE ROCKEFELLER DRUG LAWS by James Durand Wilson, Sr. Advisor: Dr. Michael J. Smith The purpose of this research study was to explore the impact of separation upon previously imprisoned mothers separated from their children, due to drug offense convictions under the long-term mandatory incarceration statues of New York's Rockefeller Drug Laws (RDL). A purposeful sample of previously incarcerated mothers under the RDL recruited from the Women's Prison Association & Home, Inc. (WPA) made up the sample for this study. In this qualitative study, these 22 mothers of color, from the lower socio-economic stratum, described their experiences as women addressing motherhood from upstate behind prison walls. The majority of these respondents were African-American, with one Jamaican, one Panamanian, and two Puerto Rican Americans. While 16 of the 22 mothers (72%) reported having a limited education, three (14%) held high school diplomas, and another three (14%) had attended college. The ages of these research respondents ranged from 27 to 53 years. When these 22 mothers went to prison they left 62 children behind in the community for approximately 133 years. Major areas examined were: events that led to the mothers' incarceration; child care arrangements; addressing motherhood from behind prison walls; mothers' emotional reactions to contacts; mothers' relationships to their children's caregiver; mothers' emotional adjustment to separation; termination of parental rights; and respondents' reactions to the Rockefeller Drug Laws (RDL) and the Reform Act of 2004 (Reform Act). When taken together, these different areas provide a comprehensive perspective on the lives of formerly incarcerated mothers separated from their children. This researcher found that there were multiple events that led to the mothers' imprisonment, all related to the mothers' experience of substance abuse and drug addiction. Responsibility for child care was assumed by extended family in the majority of cases. Mothers maintained contact with their children via three mechanisms: (1) in-person visits in the prison; (2) telephone contacts; and (3) mail, including cards, letters and photographs. Twenty out of the 22 mothers maintained some type of contact with their children while in prison. Mothers' emotional reactions to these contacts ranged from feelings of guilt and anger to feelings of happiness and joy. A key variable was the mother's relationship to the child's caregiver. Criteria were developed to evaluate the mother/caregiver relationship based on the above types of contact. It was found that eight (36%) of the mothers had a highly positive relationship with their children's caregiver, seven (32%) had a moderately positive relationship, five (23%) had a minimally positive relationship and two (9%) had a negative relationship. Mothers expressed a variety of emotional adjustments to separation. By far the most commonly referred adjustment reaction was depression due to loneliness. Mothers also noted a sense of profound sadness and many coped with this through emotional disconnection. Some mothers faced the issue of termination of their parental rights. Eight (36%) of the mothers reported that their parental rights had been terminated. In a majority of cases, mothers initiated this termination as a way of providing more security for their children by ensuring adoption by other family members. The mothers' reactions to the RDL and the Reform Act were unanimous in that they felt the laws were unfair, unduly harsh, and a non-productive law which had no interest in rehabilitation. The Reform Act was seen as a minimal improvement, as only 2.8% of those imprisoned under the RDL were eligible for reform consideration. In conclusion, this researcher found that the RDL were harmful to mother-child relationships. Extended incarceration, combined with distance from their children, negatively impacts the mother-child bonding experience. Recommendations include achieving the repeal of the RDL. In lieu thereof, this researcher offers the following recommendations: relocating incarcerated mothers closer to home; developing better supports for visitation; periodic three-day retreats to encourage bonding; and improved community-based support for caregivers. Future research is needed to longitudinally examine the long-term effects of incarceration as a result of the Rockefeller Drug Laws.