LGBT Health Care Needs Assessment; Community Based Participatory Research

This project aims to assess the health care needs of the lesbian, gay, bisexual and transgender (LGBT) communities in Dallas. Members of the LGBT communities experience considerably worse health outcomes than heterosexuals. LGBT people are more likely to experience mental health problems, delay seeking medical care and receive emergency health care. LGBT people are less likely to have insurance or have a primary care provider. LGBT people face limited health care access, insurance coverage difficulties, a paucity of culturally competent health care providers, as well as discrimination and harassment. Due to a dearth of studies of health in sexual and gender minorities, no comprehensive understanding of LGBT healthcare exists. To identify the health care needs of the LGBT communities in Dallas, we are utilizing community based participatory research (CPBR). This collaborative research methodology is designed in order for community members to work alongside social scientists. CPBR allows this research project to be designed, organized and disseminated with the LGBT communities in mind. Data collected will assess health care deficits and needs of the LGBT communities. The results will drive future research that may benefit LGBT communities by providing evidence of health care disparities in order to reduce such disparities.

Department of State Health Services Project – National HIV Behavioral Surveillance Data

In 2003, the CDC created the National HIV Behavioral Surveillance to study behavioral trends among persons at risk for contracting HIV. The three target demographics are men who have sex with men, injection drug users, and heterosexuals at increased risk for HIV infection. Each participant completes a questionnaire to gather information on HIV-related risk behaviors, HIV testing, and use of HIV prevention services. Our Center is currently collaborating with the Texas Department of State Health Services to analyze the data collected in Texas from men who have sex with men and disseminate our findings at professional conferences and in professional journals.

African American Men Who Have Sex With Men; Community Based Participatory Research

African American males and men who have sex with men are at significant risk of contracting and transmitting HIV, and African American men who have sex with men (AAMSM) are at even higher risk due to a variety of factors. Community based participatory research (CBPR) is a collaborative approach to research in which social scientists and community members mutually plan and carry out all aspects of the research process to improve community health, CBPR is a promising avenue for tapping into issues pertinent to AAMSM. The purpose of this study is to conduct CBPR among AAMSM and to identify issues relevant to AAMSM. Findings will inform the development of an intervention to be tested with federal funds targeted to reduce HIV incidence/prevalence in African-American communities.

Exercise Intervention for Psychoneuroendocrine Comorbidities and Relapse Prevention in Women Recovering from Substance Abuse

The Centers for Disease Control and Prevention estimates that 13-16 million people in the U.S. (1.5 million Texans) suffer from substance (alcohol or drug) dependence or abuse. Each year about 1 million women receive treatment for substance abuse from a specialty inpatient or outpatient facility. There is a clear need for successful substance abuse treatment programs for women.

One of the most challenging aspects of substance abuse treatment is preventing relapse into drug use following discharge from the treatment program. Despite proven efficacy of treatment programs, the relapse rate in the first year following discharged generally ranges from 60-90 percent. The underlying mechanisms for this high relapse rate are complex and include physiological and psychological factors. Among the mechanisms of action associated with increased risk of drug relapse is the ability to manage acute stress which is greatly affected by the physiological (neuroendocrine) responsiveness and the state of depression, mood, self-efficacy, and coping. In fact the responsiveness of the neuroendocrine hypothalamic-pituitary-adrenal (HPA) axis to a stressful situation can significantly predicted relapse and time to first use following abstinence and HPA axis function as a target of anticraving treatment.

Our long-term goal is to improve quality of life and years of healthy living without relapse for women recovering from substance abuse by reducing the severity of co-morbid conditions through comprehensive cost-effective health promotion programs. The purpose of the proposed research is to test the efficacy of a combined resistance and aerobic exercise training intervention to manage clinically relevant psychoneuroendocrine co-morbid conditions in order to reduce relapse in women recovering from substance abuse.

Weight training: A treatment for muscle wasting from the interaction of long-term substance abuse and infection with HIV

The synergy of long-term substance abuse and human immunodeficiency virus (HIV) can result in the development of co-morbidities including substantial muscle wasting. The muscle wasting appears to be caused largely by a negative muscle protein balance (net loss of muscle protein). Resistance (weight) training improves several measures of health including increases in muscle protein synthesis and muscle mass. Thus resistance training could be an important tool in reversing long-term substance abuse and HIV induced muscle wasting. Currently no research appears to have been published on the effect of resistance training on the interaction of long-term substance abuse and HIV. The purpose of this study is to examine the effect of 6 weeks of resistance training on the interaction of long-term substance abuse and HIV on measures of physiological and psychological health in men undergoing in-patient treatment for substance abuse.

Project Heart

Heart Rate Variability (HRV) is a typical health measure of stress in cardiovascular disease; however, little research has examined its usefulness in HIV populations. Additionally, recent debates surrounding the use of cortisol as a traditional biological maker for stress in people living with HIV also creates a need for better ways to measure stress in HIV-positive populations. The purpose of this study is to examine the relationship between HRV and stress from HIV-related stigma in people living with HIV/AIDS. An important goal for this study is to determine whether forgiveness moderates the relationship between HIV stigma-related stress and HRV. Should stigma or forgiveness play a significant role in HRV, this study will make an important contribution to intervention research. Forgiveness coping skills can be taught to HIV-positive people to assist in the management of the stigma associated with living with HIV/AIDS. Currently, this project is undergoing IRB approval.

Project Health

The purpose of this study is to inventory medical conditions and health behaviors that impact the Lesbian, Gay, Bisexual and Transgendered (LGBT) communities of the Dallas Metroplex area. Additionally, we are assessing psychosocial factors, such as social support, stress, and coping to gain a better understanding of the diverse LGBT communities. Our study is designed to build onto the existing LGBT literature by examining health-related behaviors (e.g., obesity and smoking) and risk factors associated with cancers (i.e. lung, breast, cervical, testicular, anal, and non-Hodgkin's lymphoma), coronary vascular disease (hypertension, atherosclerosis, and peripheral vascular disease) and chronic obstructive pulmonary disease. Additionally, we are examining discrimination in healthcare settings for LGBT peoples, which may lead to negative experiences and hostility toward healthcare providers, and the role of disclosure as a risk factor for poor health outcomes. Ultimately, our research will identify the basic healthcare needs for the different LGBT communities and potential barriers that may be deterring the different communities from obtaining optimal care. Currently, this project has IRB approval and participant recruitment and data collection are underway.

Project Forgive

Previous research completed at the UNT Center for Psychosocial Health Research identified a statistically significant relationship between specific forms of stress (HIV-related stigma), and coping strategies (forgiveness) with the outcome variables of depression, perceived stress, QOL, adherence to HIV medications and risky sexual behavior. Project Forgive was conceptualized from those results and is unique in that it draws on previous intervention research that focuses on “forgiveness” as an effective coping strategy for health-related problems, and now applies it to HIV+ populations. The purpose of this randomized clinical trial is to develop and pilot a secondary prevention intervention that targets depression, stress, quality of life and risky behaviors in HIV+ women. Lazarus and Folkman’s deficit model of stress and coping argues that stress and subsequent unhealthy-related behaviors are a result of a deficit in coping resources available to the individual. By teaching cognitive behavioral forgiveness skills, we will potentially offset deficits specific to HIV+ adults by enhancing the coping resources available to them. Specific goals of the study include: decreasing depression related to HIV+ status, reducing feelings of anger toward HIV+ status, increasing the use of forgiveness as a general problem-solving strategy, and improving the participant’s psychological, emotional, and spiritual functioning. Currently, this project has IRB approval and presentations and publications are underway.

Project Cope
The purpose of this survey-based study is to identify whether certain life stressors cause individuals to use particular coping strategies. Project cope seeks to identify the relationship among all types of unsupportive social interactions (blaming, minimizing, distancing, bumbling) and the use of maladaptive coping mechanisms. Specifically, our study seeks to examine coping styles associated with specific stressors as potential mediators of the relationship between unsupportive social interactions and adjustment. We hypothesize that the unsupportive social interactions (that result from an individual’s most recent negative life event) will be associated with depression and self-reported physical symptoms in individuals. Examining these variables and relationships in an undergraduate population will provide a foundation for future research in this area, particularly the development of interventions that manipulate various psychosocial variables to improve coping for people in stressful situations. Project Cope collects cross-sectional correlational data that will help future studies examine similar relationships between stressors, unsupportive social support, and coping strategies in specific disease populations. Currently, this project has IRB approval and presentations and publications are underway.

Growing Up Positive

Although the Center for Disease Control (CDC) estimates that 13,125 people under the age of 25 are living with HIV/AIDS in the United States, the focus of current research on the development of interventions to reduce stress and increase coping and quality of life in people living with HIV/AIDS is limited primarily to adults. This pilot study is the first step in the development of a psychosocial intervention to increase positive health related behaviors, reduce risky behaviors and improve overall physical and mental health in HIV+ adolescents. Through GUP (Growing Up Positive), we will be collecting data that will demonstrate how psychosocial stressors are associated with health behaviors in HIV+ adolescents (between the ages of 15 and 24), with a long-term goal of using the data to develop an intervention for HIV+ adolescents. Data will be collected both qualitatively, through one-on-one interviews and focus groups, and quantitatively, through the administering of surveys; each will concentrate on prevalent stressors (e.g., HIV-related stigma, disclosure concerns, HIV-related symptoms), coping mechanisms (e.g., substance use, social support), and outcome (e.g., medication adherence, depression, anxiety). Research in this population is important because adolescence is a time when an individual shapes his/her identity through behavioral experimentation, risk taking, and becoming independent. The average adolescent struggles in dealing with issues such as dating, sexual activity, intimacy, career paths, and experimentation with drugs and alcohol; all these issues can be overwhelming, and are further compounded for adolescents living with HIV/AIDS.

Project CAM
Although the advent of antiretroviral medications has extended the life expectancies of people living with HIV/AIDS (PLH), the medications come with additional noxious side-effects. To counter the side effects of these medications, many PLH report the use of Complementary and Alternative Medicine (CAM) therapies and treatments to supplement their mainstream medical regimes. Consequently, Project CAM was developed in order to expand the knowledge base regarding CAM usage in HIV+ adults and focus on improving health-care management and quality of life in PLH. Project CAM assessed the experience of CAM usage among HIV+ adults in the Dallas/Fort Worth area and featured four structured focus groups. Each focus group consisted of 10 people (five males and five females). The focus group discussions were centered on discovering the many facets of the participants’ CAM usage, such as the benefits and setbacks of CAM. Following the focus groups, participants completed surveys consisting of specific questions about personal CAM use, health-related behaviors, and psychosocial variables. The data collection phase for this project has ended and data analysis is underway. Presentations and publications are being submitted with the information from this project.

Primary Prevention: Sexual Behavior Among College Students
In terms of preventing the spread of HIV, there are two main approaches to HIV education and prevention. While primary prevention focuses on educating people about various risky behaviors and aims to reduce the transmission of HIV, secondary prevention aims to keep a person who is currently living with HIV as healthy as possible. This study focused on primary prevention and examined the psychosocial factors and behaviors that predict risky sexual behaviors in a large sample (n > 600) of undergraduate students at the University of North Texas. The purpose of this study was to determine what factors influence risky sexual behaviors in young adults; in doing so, researchers can formulate educational services and appropriate programs to encourage individuals to engage in safer sexual behaviors. Sexual interaction includes any sexually related behaviors that may put an individual at risk for a sexually transmitted disease. The data collection phase for this project has ended and data analysis is underway. Presentations and publications are being submitted with the information from this project.

Project Voices
The purpose of Project Voices is to examine how HIV-related Stigma HIV-related stigma, sometimes referred to as “the second epidemic” in HIV, is often associated with health and health behaviors in people living with HIV/AIDS. The purpose of Project Voices was to learn about these associations and further understand how stigma contributes to poor health outcomes and other health-related behaviors. In addition, the study also provides an evaluation of the experiences of PLH as it relates to overall psychosocial health. Project Voices is survey-based and covers a variety of topics and issues, including: medical care, substance use, coping resources, risky behaviors, acculturation, social support, and perceived stress. Findings from this study will be used to develop interventions for people living with HIV/AIDS to improve their coping skills and quality of life. Project Voices included a total of 280 participants (140 male and 140 female) of various ethnicities and backgrounds. The data collection phase for this project has ended and data analysis is underway. Presentations and publications are being submitted with the information from this project.

Peer Reviewed Published Abstracts ( * denotes student co-author)

Li, W., Stephen K., Wike, A. & Vosvick, M. (2014, August). Relationship between stress, behavioral disengagement, self-esteem and self-efficacy in and HIV-positive population. Poster presentation Society of Behavioral Medicine, San Antonio, Texas.

Ramos, S., Guerrero, A. J. & Vosvick, M. (2014, August). Daily Hassles, HIV Stigma and Positive States of Mind: an Exploration of Stress Perception in People Living with HIV. Poster presentation at Society of Behavioral Medicine, San Antonio, Texas.

Bonds, S. E. & Vosvick, M. (2014, August). Sexual risk, self-esteem, stress, shame: Correlates of psychological quality of life in a LGB sample. Poster presented at American Psychological Association Annual Convention, Washington, DC.

Stem, W., Bonds, S. & Vosvick, M. (2014, May). Correlates of resilience in an HIV+ sample: Behavioral disengagement, optimism and HIV-related stigma. Poster presentation at Association for Psychological Science Annual Convention, San Francisco, CA.

Palmer, S., Stem, W., Vosvick, M. (2015, April). Role of Self Forgiveness, HIV Stigma & Social Support: Psychological Quality of Life in HIV+ Sample. Poster presentation at Society of Behavioral Medicine Annual Meeting, San Antonio, TX.

Kirkham, C., Wike, A. & Vosvick, M. (2014, March). Correlates of Health Distress in an HIV+ Sample: Perceived Stigma, Symptom Load, Positive States of Mind and Life Regard. Poster Presentation at American Psychosomatic Society Annual Meeting, San Francisco, CA.

Schumacher, M., Purser, M. & Vosvick, M. (2013, April). Anger, Forgiveness and Mindfulness: Correlates of Stress in an LGB Sample. Poster Presentation at Society for Behavioral Medicine Annual Meeting, San Francisco, CA.

Martin, L. & Vosvick, M. (2013). Minority Status, Attachment and Forgiveness as Predictors of Quality of Life. Annals of Behavioral Medicine, Supplement, Vol. 45, D-086g. Paper presented at 34th Annual Society of Behavioral Medicine Convention, San Francisco, CA

Gomez, B., Chng, C. L. & Vosvick, M. (2013). The Roles of Stress and Behavioral Disengagement: Perceived Stigma in HIV-positive Adults. Annals of Behavioral Medicine, Supplement, Vol. 45B-068. Paper presented at 34th Annual Society of Behavioral Medicine Convention, San Francisco, CA

Wike, A. & Vosvick, M. (2013). Coping and Mindfulness: Implications for Anxiety Reduction in LGBT Communities. Annals of Behavioral Medicine, Supplement, Vol. 45, A-212. Paper presented at 34th Annual Society of Behavioral Medicine Convention, San Francisco, CA

Wike, A. & Vosvick, M. (2013). Mindfulness and Positive States of Mind: Correlates of Anxiety in the LGBT Community. Annals of Behavioral Medicine, Supplement, Vol. 45, A-213. Paper presented at 34th Annual Society of Behavioral Medicine Convention, San Francisco, CA

Purser, M. & Vosvick, M. (2013). Spirituality, Self-Efficacy and Social Support: Correlates of Psychological QOL in People Living with HIV. Annals of Behavioral Medicine, Supplement, Vol. 45, A-070. Paper presented at 34th Annual Society of Behavioral Medicine Convention, San Francisco, CA

Lopez, E.* & Vosvick, M. (2012). HIV-related Stigma, Forgiveness and resilience: A Mediation Analysis. Annals of Behavioral Medicine, Supplement, Vol. 43, B-065. Paper presented at Society of Behavioral Medicine Convention, San Francisco, CA.

Miller, J.* & Vosvick, M. (2012). Forgiveness of Self: A Link Between Control and Resiliency. Annals of Behavioral Medicine, Supplement, Vol. 43, D-064. Paper presented at Society of Behavioral Medicine Convention, San Francisco, CA.

Guerrero, A. J.*, Chng, C. L., Fritz, S.* & Vosvick, M. (2012). Correlates of Perceived Stress in the Lesbian, Gay and Bisexual Communities: Self-esteem, Heterosexism and Depression. Paper at the American Public Health Association Convention, San Francisco, CA.

Bidwell, J.*, Chng, C. L., Vosvick, M. & Lopez E* (2012). Adherence to HAART in HIV-positive Populations: Social Support, Stress and Coping. Poster at the American Public Health Association Convention, San Francisco, CA.

Stem, W.*, Chng, C. L., Lopez E* & Vosvick, M (2012). Mindfulness, Self-esteem and Positive States of Mind: Correlates of Psychological Quality of Life in an LGBT Sample. Poster at the American Public Health Association Convention, San Francisco, CA.

Fritz, A.* & Vosvick, M. (2011). Trait Anxiety & Resilience: Correlates of HIV-related Personalized Stigma. Annals of Behavioral Medicine. Paper presented at Society of Behavioral Medicine Convention, Washington, DC.

Miller, J.* & Vosvick, M. (2011). Self-efficacy for Managing HIV/AIDS: The Influence of Mindfulness, Life Orientation and Life Regard. Annals of Behavioral Medicine. Paper presented at Society of Behavioral Medicine Convention, Washington, DC.

Purser, M.* & Vosvick, M. (2011). The Relationship Between Psychosocial Factors and Adherence in HIV+ Women. Annals of Behavioral Medicine. Paper presented at Society of Behavioral Medicine Convention, Washington, DC.

Steinberg, T.* & Vosvick, M. (2011). Predictors of HIV-related Neurocognitive Impairment in an HIV/AIDS Population. Annals of Behavioral Medicine. Paper presented at Society of Behavioral Medicine Convention, Washington, DC.

Martin, L.* & Vosvick, M. (2011). Forgiveness, Attachment and Physical Health Quality of Life (PHQOL) in HIV+ Adults. Annals of Behavioral Medicine. Paper presented at Society of Behavioral Medicine Convention, Washington, DC

O’Neil, K.*, Vosvick, M. & Deaton K* (2010). Trauma, Emotional Focused Coping and Self-Esteem in Gay Men and Lesbians. Annals of Behavioral Medicine, Vol.39, Supplement, D-145. Paper presented at Society of Behavioral Medicine Convention, Seattle, WA.

Lopez, E.J.*, Vosvick, M. & DeSena, T.* (2010). Mind Over Body: Predictors of Perceived Health in the Gay Community. Annals of Behavioral Medicine, Vol. 39, Supplement, B-092. Paper presented at Society of Behavioral Medicine Convention, Seattle, WA.

Rocha, C. V.*, Vosvick, M., DeSena, T.* & Chng, CL (2010). Hold me closer: Romantic Attachment Style and Sexual Function in Lesbians and Gay Men. Annals of Behavioral Medicine, Vol. 39, Supplement, A-128. Paper presented at Society of Behavioral Medicine Convention, Seattle, WA.

Wray, A. L.*, Vosvick, M. & Chng, C.L. (2010). Correlates of Mental Quality of Life in Lesbians and Gay Men: Discrimination, Negative Social Exchange and Low Self-esteem. Annals of Behavioral Medicine, Vol. 39, Supplement, A-094. Paper presented at Society of Behavioral Medicine Convention, Seattle, WA.

Ridings, J.*, Vosvick, M. & Chng, C.L. (2010). Self-efficacy for Managing HIV: Life Regard, Mindfulness, and Forgiveness. Annals of Behavioral Medicine, Vol.39, Supplement, A-057. Paper presented at Society of Behavioral Medicine Convention, Seattle, WA.

Deaton, K.*, Vosvick, M. & Hill, J.* (2009). Gender Differences in Coping Strategies of HIV+ Adults: Trauma and Forgiveness. Annals of Behavioral Medicine, Vol. 37, Supplement, D79. Paper presented at Society of Behavioral Medicine Convention, Montreal, Canada.

Wray, A.*, Vosvick, M. & Chng, C. (2009). Forgiveness in HIV+ Adults: Anger, Stigma and Health Distress. Annals of Behavioral Medicine, Vol. 37, Supplement, D81. Paper presented at Society of Behavioral Medicine Convention, Montreal, Canada.

Lewis, A.* Vosvick, M. (2009). Mental Health & Cognitive Functioning in HIV+ Adults: Anger and Social Support. Annals of Behavioral Medicine, Vol. 37, Supplement, D82. Paper presented at Society of Behavioral Medicine Convention, Montreal, Canada.

Perales, M.* & Vosvick, M (2009). Mental Health Correlates in HIV+ Adults: Self-efficacy, Control & Loneliness. Annals of Behavioral Medicine, Vol. 37, Supplement, D78. Paper presented at Society of Behavioral Medicine Convention, Montreal, Canada.

Steinberg, T.*, Vosvick, M. & Smith, N. (2009). Condom Use in HIV+ Adults: Religion/Spirituality & Optimism. Annals of Behavioral Medicine, Vol. 37, Supplement, D72. Paper presented at Society of Behavioral Medicine Convention, Montreal, Canada.

Hill, J.*, Vosvick, M. & Hua W* (2009). Religious Coping, Self-esteem and Locus of Control: Mindfulness in an HIV+ Population. Annals of Behavioral Medicine, Vol. 37, Supplement, C86. Paper presented at Society of Behavioral Medicine Convention, Montreal, Canada.

Renwick, A.*, Vosvick, M. & Chng, C. (2009). HIV-related Stigma: Denial, Anger & Self-esteem. Annals of Behavioral Medicine, Vol. 37, Supplement, B82. Paper presented at Society of Behavioral Medicine Convention, Montreal, Canada

Martin, L.* & Vosvick, M. (2008). The role of negative affect, loneliness, and positive affect in quality of life. Annals of Behavioral Medicine, Vol. 35, Supplement, D115. Paper presented at Society of Behavioral Medicine Convention, San Diego, CA.

Hua, W.Q.* & Vosvick, M. (2008). Spirituality, Forgiveness, and Stigma in HIV+ Women. Annals of Behavioral Medicine, Vol. 35, Supplement, C200. Paper presented at Society of Behavioral Medicine Convention, San Diego, CA.

Hill, J.* & Vosvick, M. (2008). Forgiveness and Loneliness in HIV+ Women: Anxiety’s Correlates. Annals of Behavioral Medicine, Vol. 35, Supplement, C107. Paper presented at Society of Behavioral Medicine Convention, San Diego, CA.

Ridings, J.* & Vosvick, M. (2008). Stigma, Forgiveness and Depression in HIV+ Women. Annals of Behavioral Medicine, Vol. 35, Supplement, C187. Paper presented at Society of Behavioral Medicine Convention, San Diego, CA.

Kamrudin, A.* & Vosvick, M. (2008). Trauma History, Self-Esteem and Perceived Stress: Correlates of Emotional Well-Being. Annals of Behavioral Medicine, Vol. 35, Supplement, C188. Paper presented at Society of Behavioral Medicine Convention, San Diego, CA.

Martin, L.* & Vosvick, M. (2007). Self-isolation or distancing: Gender differences in HIV-related coping and depression. Annals of Behavioral Medicine, Vol. 33, Supplement, S181. Paper presented at Society of Behavioral Medicine Convention, Washington, DC.

Smith, S.* & Vosvick, M. (2007). Optimism and forgiveness in HIV+ adults. Annals of Behavioral Medicine, Vol. 33, Supplement, S132. Paper presented at Society of Behavioral Medicine Convention, Washington, DC.

Smith, S.*, Volpone, S.* & Vosvick, M. (2007). Coping and forgiveness in HIV+ Adults. Annals of Behavioral Medicine, Vol. 33, Supplement, S133. Paper presented at Society of Behavioral Medicine Convention, Washington, DC.

Volpone, S.* & Vosvick, M. (2007). Forgiveness as a predictor of depression in HIV+ adults. Annals of Behavioral Medicine, Vol. 33, Supplement, S133. Paper presented at Society of Behavioral Medicine Convention, Washington, DC.

Vosvick, M. & Chng, C.L. (2006). Life after a Decade with HIV: Religiosity, Avoidance and Humor as Coping Stratagems. Annals of Behavioral Medicine, Vol. 31, Supplement, S130. Paper presented at Society of Behavioral Medicine Convention, San Francisco, CA.

Scherbarth, A. *, Ranucci, M.* & Vosvick, M. (2006). Trauma, Dispositional Forgiveness and Depression in People Living with HIV/AIDS. Annals of Behavioral Medicine, Vol. 31, Supplement, S150. Paper presented at Society of Behavioral Medicine Convention, San Francisco, CA.

Harris, J. B.*, Scherbarth, A.* & Vosvick, M. (2006). Predictors of Health Protective Sexual Communication: Depression and STD Attitudes. Annals of Behavioral Medicine, Vol. 31, Supplement, S050. Paper presented at Society of Behavioral Medicine Convention, San Francisco, CA.

Vosvick, M. (2005). Correlates of Maladaptive Coping Strategy Selection in HIV+ Adults: Stigma, Pessimism and Forgiveness. Annals of Behavioral Medicine, Vol. 29, Supplement, S107. Paper presented at Society of Behavioral Medicine Convention, Boston, MA.

Ballinger, J.* & Vosvick, M. (2005). Somatic Symptoms, Meditation Practice and Positive Psychosocial Factors as Correlates of Stress in HIV+ Adults Who Use Complementary and Alternative Medicine. Annals of Behavioral Medicine, Vol. 29, Supplement, S188. Paper presented at Society of Behavioral Medicine Convention, Boston, MA.

Clay, S.*, Scherbarth, A.* & Vosvick, M. (2005). Spirituality, Self-esteem and Depression in HIV+ Adults Who Use Complementary and Alternative Medicine. Annals of Behavioral Medicine, Vol. 29, Supplement, S049. Paper presented at Society of Behavioral Medicine Convention, Boston, MA.

Ranucci, M. B.*, Stephen, V.E.* & Vosvick, M. (2005). Stigma and HIV: A Review of Quantitative Empirical Literature. Annals of Behavioral Medicine, Vol. 29, Supplement, S107. Paper presented at Society of Behavioral Medicine Convention, Boston, MA.

Dickson, D.* & Vosvick, M. (2005). Sleep Disturbance, Stigma and Pain in HIV+ Adults who use Complementary and Alternative Medicine. Annals of Behavioral Medicine, Vol. 29, Supplement, S147. Paper presented at Society of Behavioral Medicine Convention, Boston, MA.

Schickedanz, J.*, Ranucci, M.* & Vosvick, M. (2005). Depression, Stress, and Disclosure’s Relationship to Negative Self-Image in People Living with HIV/AIDS. Annals of Behavioral Medicine, Vol. 29, Supplement, S178. Paper presented at Society of Behavioral Medicine Convention, Boston, MA.

Ranucci, M. B.*, Duran, R. & Vosvick, M. (2005). Psychosocial and Behavioral Factors Associated with Stigma in HIV+ Adults: Adherence, Coping, Disclosure, Forgiveness and Gay Identity. Annals of Behavioral Medicine, Vol. 29, Supplement, S106. Paper presented at Society of Behavioral Medicine Convention, Boston, MA.

Thomas, C.* & Vosvick, M. (2005). Hope, Health Perception, and Unsafe Sex In Relation To Self-Efficacy in Health Management among HIV+ Adults using Complementary/Alternative Medicine. Annals of Behavioral Medicine, Vol. 29, Supplement, S192. Paper presented at Society of Behavioral Medicine Convention, Boston, MA.

Vosvick, M. (2004). HIV-Related Stigma, Stress and Social Support as Predictors of Symptom Load. Abstract, Annals of Behavioral Medicine S104. Paper presented at Society of Behavioral Medicine Convention, Baltimore, MD.

Vosvick, M. & Chiapa-Scifres, A.* (2004). Ethnic Identity and Perception of Stigma in People Living with HIV/AIDS. Abstract, Annals of Behavioral Medicine S40. Paper presented at Society of Behavioral Medicine Convention, Baltimore, MD.

Vosvick, M. & Scherbarth, A.* (2004). HIV-Related Stigma, Forgiveness and Quality of Life in a Diverse HIV+ Population. Abstract, Annals of Behavioral Medicine S40. Paper presented at Society of Behavioral Medicine Convention, Baltimore, MD.

Vosvick, M. & Saxon, L.* (2004). Correlates of HIV-related Stigma: Psychosocial and Somatic Factors. Abstract, Annals of Behavioral Medicine S40. Paper presented at Society of Behavioral Medicine Convention, Baltimore, MD.

Vosvick, M. & Gutowski, M.* (2004). Pain Perception in HIV+ Men and Women: The Effects of Psychological and Physiological Components. Abstract, Annals of Behavioral Medicine S59. Paper presented at Society of Behavioral Medicine Convention, Baltimore, MD.

Vosvick, M. & Ranucci, M.* (2004). Stigma, Coping, Pessimism and Symptom Load: Covariates of Depression in Men and Women with HIV/AIDS. Abstract, Annals of Behavioral Medicine S57. Paper presented at Society of Behavioral Medicine Convention, Baltimore, MD.

Vosvick, M. & Ballinger, J.* (2004). Correlates of Stress in People Living with HIV/AIDS. Abstract, Annals of Behavioral MedicineS59. Paper presented at Society of Behavioral Medicine Convention, Baltimore, MD.

Vosvick M, Gore-Felton, C., Ashton, E.*, Koopman, C., Fluery, T., Israelski, D., & Spiegel D. (2003). Sleep disturbances among diverse HIV-positive men and women: the role of pain, stress and social support. Abstract, Annals of Behavioral Medicine. 25(2003 Supplement), S113. Paper presented at Society of Behavioral Medicine Convention, Salt Lake City, UT.

Vosvick M, Gore-Felton, C., Brondino, M., Koopman, C. & Spiegel D. (2002). Predictors of depression among adults living with HIV/AIDS: the role of quality of life and maladaptive coping. Abstract, Annals of Behavioral Medicine. 24 (2002 Supplement), S045. Paper presented at Society of Behavioral Medicine Convention, Washington, DC.