As HIV/AIDS continues to disproportionately impact men who have sex with men (MSM) (CDC, 2010a), effective and timely prevention strategies for this population must be developed. Specifically, evidence-based interventions that can be easily adapted and have proven effectiveness are needed. Hence, the purpose of the current study was to assess the impact of the Mpowerment Project (Hayes, Rebchook, & Kegeles, 2003), a community level HIV prevention program originally designed for young urban gay men, when adapted for rural gay men. The Mpowerment Project is recognized as evidence- based intervention by the CDC (CDC, 2009b). The current study is an extension of this research, assessing Mpowerment model fidelity and the behavioral and attitudinal changes that occurred among participants. Data were collected from participants in a rural area of southeast Idaho from 2002-2004. Data were collected prior to M-Group participation and at a three months follow-up. The 66 individuals completing the M-Group pre and posttest assessment also attended a minimum of three study events and a maximum of 226 events. Results revealed no significant changes in attitudinal variables and all but one behavioral variable among Rural Mpowerment (R-MP) participants. The one significant behavior change was an increase in reported safer sex discussion among friends, indicating a possible change in the social norm regarding safer sex. Results also indicate that program fidelity was maintained and the Mpowerment Project is adaptable to rural areas. However, there was no indication of attitudinal changes in participants of this study. There were no changes in behavioral variables aside from discussion about safer sex with friends increasing. The lack of evidence-based interventions for rural gay men highlights the need for further research on the community impact of the Mpowerment Project on rural participants.

Human Immunodeficiency Virus (HIV) continues to disproportionately affect men who have sex with men (MSM). Gay, bisexual, and other MSM are estimated to account for two percent of the population, yet they constitute more than half of all individuals living with HIV in the United States (Centers for Disease Control [CDC], 2010). Collectively, both HIV-diagnosed (HIV-D) and HIV-nondiagnosed (HIV-ND) MSM report a variety of reasons for intentional and unintentional nonuse of condoms. Depending on partner status, HIV-D MSM are in the unique position of having the potential both to increase risk of infecting others with HIV and to expose themselves to further complication (e.g., superinfection) when they engage in unprotected anal intercourse (UAI). HIV-ND MSM are at risk of seroconversion each time they engage in UAI with an infected partner or partner of unknown HIV status. Elucidating reasons for continued engagement in UAI specific to both HIV-D and HIV-ND MSM likely is an important step in the process of effective prevention. The current study employed meta-analytic methods to evaluate HIV-risk correlates in both HIV-D and HIV-ND MSM. In addition to several individual risk correlates, within the context of the Information-Motivation-Behavioral Skills Model, Behavioral Skills variables were related to condom use in HIV-ND MSM and Motivation variables were related to condom use in both HIV-D and HIV-ND MSM. A sufficient number of studies were not available to examine Information-based risk correlates in either subgroup. Results of the present study may guide future best practice in harm reduction for both HIV-D and HIV-ND MSM

L'optique non linéaire sur silicium a pris son essor en raison des nombreuses perspectives d'applications à l'optoélectronique en circuit intégré. Pour observer des effets non-linéaires sans travailler à des puissances trop élevées, il faut utiliser des résonateurs à très haut facteur de confinement optiques (Q/V). Les microcavités à cristal photonique bidimensionnel sont une technologie mature et planaire pour réaliser de tels résonateurs sur silicium. Au cours de cette thèse, nous avons travaillé sur une application des microcavités à cristal photonique à la détection télécom. Le silicium est en effet transparent dans cette plage de longueurs d'onde, sauf si on atteint des densités de puissance élevées, auquel cas l'absorption à deux photons intervient. Le principe du détecteur repose sur l'exaltation de absorption à deux photons grâce à la microcavité en cristal photonique. La collection des porteurs ainsi générés est assurée par une jonction latérale métal-semiconducteur-métal (MSM). Nous avons d'abord étudié numériquement la viabilité du concept du détecteur sous deux aspects : collection des porteurs libres à travers le cristal photonique et influence des métallisations sur le facteur de qualité. Les modèles standards pour le courant d'obscurité et le photocourant dans les photodétecteurs MSM ont été étendus pour tenir compte du cristal photonique. La fabrication d'une jonction MSM dans le cristal photonique a fait l’objet d’un travail approfondi en salle blanche de l’IEF. La mesure du courant circulant dans le dispositif a permis de mettre en évidence un photocourant résonnant. On retiendra que la réponse peut alors atteindre 90 mA/W et que la bande-passante est supérieure au GHz. Outre la démonstration du détecteur en elle-même, des résultats originaux ont été obtenus. Nous avons montré qu'il est possible de contrôler les densités de porteurs dans les microcavités à cristal photonique en jouant sur la polarisation externe. Enfin, le détecteur est un moyen de mesurer certaines grandeurs essentielles de la physique des microcavités sur silicium, comme l’absorption linéaire résiduelle ou la résistance thermique de la cavité. / Silicon non linear optics is of considerable interest to the scientific community because of its applications to integrated optoelectronics. In order to observe non linear phenomena at a reasonable power, one has to work with very high confinement factor (Q/V) optical resonators. As they are now a fully mastered planar technology, two-dimensional photonic crystal microcavities are an efficient way of actually obtaining such resonators in silicon. In this thesis, an application of photonic crystal microcavities to telecom wavelength detection is demonstrated. Bulk silicon is transparent at these wavelengths, except when working at very high power density. Only then, two-photon absorption (TPA) becomes significant. In our detector, TPA is enhanced in the microcavity. A metal-semiconductor-metal (MSM) junction then ensures very fast carrier collection. We studied the physics of the detector and focused on two aspects: collection of carrier in a photonic crystal, and impact of the metal on the optical quality factor. Standard models for dark current and photocurrent in MSM junctions were adapted to the photonic crystal case study. Fabrication of the photonic crystal junction was carefully undertaken and optimized in the clean room of the IEF laboratory. The current circulating in the fabricated device resonates as the same wavelength as the optical cavity. Response can be as high as 90 mA/W, and the optical-electrical bandwidth is larger than 1 GHz. In addition to the demonstration of the detector, some original results were obtained. It is possible to control the carrier concentration in photonic crystal microcavities by tuning the external polarisation of the MSM junction. Finally, the detector allows one to measure important parameters of the physics of the cavity, such as the residual linear absorption coefficient, and the thermal resistance.

Black men who have sex with men (MSM) on Historically Black College/University (HBCU) campuses face a unique set of challenges. In addition to being disproportionately affected by HIV, Black MSM are impacted by risk behavior, stigma, and environmental policies and practices that adversely influence their experiences. The purpose of this study was to explore the experiences of Black MSM at a HBCU and how stigma, culture, social practices and the collegiate environment impact HIV risk-taking behavior. Utilizing the ecological framework and qualitative analysis, the behaviors of 13 Black MSM on a HBCU campus were examined. Personal interviews and risk assessment questionnaires were analyzed utilizing the phenomenological inquiry method. Data were inductively coded and combined into themes using a qualitative data analysis computer software package. The findings revealed that these 13 participants perceived that HIV-related risk behavior is occurring. They also noted a stigma within the current culture and expressed feelings of marginalization and a negative campus climate from students in the sexual majority. Implications for improving social change from this research include opportunities to (a) establish a culture of social responsibility and consciousness related to the integration and socialization of Black MSM; (b) dialogue regarding the campus climate; and (c) address conscious, unconscious, individual, and environmental stigmas experienced by Black MSM attending this HBCU.

<p>The HIV epidemic in the United States continues to be a significant public health problem, with approximately 50,000 new infections occurring each year. National public health priorities have shifted in recent years towards targeted HIV prevention efforts among people living with HIV/AIDS (PLWHA) that include: increasing engagement in and retention in care, improving HIV treatment adherence, and increasing screening for and treatment of substance use and psychological difficulties. This study evaluated the efficacy of Positive Choices (PC), a brief, care-based, theory-driven, 3-session counseling intervention for newly HIV-diagnosed men who have sex with men (MSM), in the context of current national HIV prevention priorities. The study involved secondary analysis of data from a preliminary efficacy trial of the PC intervention (n=102). Descriptive statistics examined baseline substance use, psychological characteristics and strategies, and care engagement and HIV-related biological outcomes. Generalized Estimating Equations (GEE) examined longitudinal changes in these variables by study condition. Results indicated that PC improved adherence to HIV treatment, but increased use of illicit drugs, specifically amyl nitrates and other stimulant drugs; additionally, moderation analyses indicated differences in patterns of change over time in viral load by baseline depression status. Implications of the findings and suggestions for future research are discussed.</p> / Dissertation

Many men who have sex with men (MSM) engage in alcohol and drug use. Drug use, particularly methamphetamines, amyl nitrates (poppers), and drugs used to treat erectile dysfunction among MSM may also contribute to risks such as unprotected sex, which leads to the possibility of contracting syphilis, Human immunodeficiency virus (HIV), and other Sexually Transmitted Infections (STIs). In the Metro Atlanta Area (Fulton and Dekalb Counties), primary and secondary syphilis rates among MSM are still rising and rank highest among the other counties in the area. Guided by the risk and protective factor theory, the purpose of this study was to determine if club drug use was a contributing factor in high-risk sexual behavior among MSM with syphilis. Data were collected from the State Electronic Notifiable Disease Surveillance System with permission from the State of Georgia's Division of Public Health's STD division and was tested by using hierarchical regression analyses. The findings were inconsistent with the reported literature; there was no association between drug use and risky sexual behavior in this sample of MSM infected with syphilis. However, there was an association between prior incarceration being predictive of engaging in sex with anonymous partners and having sex while high. Implications for positive social change include evidence for the need for public health interventions that target incarcerated MSM because they exhibit the highest-risk sexual behavior due to their time served in the correctional system. Further exploration of this topic could be used to develop health information and policies to meet the needs of those affected by high-risk sexual behavior while incarcerated and upon release, ultimately reducing the spread of HIV.

Community, Attachment, Structures and the Epidemic maps some of the changes in gay men�s experience and conceptualisation of community that have occurred during the AIDS epidemic. Social identity theory has been employed to investigate the social-psychological aspects of gay identity at personal, social and community levels. The study compares three generations of gay men in Melbourne; pre- peri- and post-AIDS. As a starting point, the study employed focus groups to explore basic conceptions of gay community. In the first of two major data collection phases, 32 gay men between the ages of 18 and 40 participated in semistructured interviews of between 45 minutes and one and a half hours. The interviews explored the men�s social networks, past and present relationship to the commercial gay scene, feelings about gay organisations businesses, neighbourhoods, entertainment, aesthetics, the way they see other gay people, their thoughts about the impact of AIDS on gay communities and their aspirations for gay communities. The second phase of data collection utilised a questionnaire developed from the analysis of the interviews. The 55 item questionnaire covered demographic information, coming out history, initial experiences of the gay world, friendship networks, feelings about the institutions, people and conceptual elements of gay community, items concerning practices of gay community, the community attachment subscale from the SAPA study and items on HIV/AIDS. The questionnaire was completed by 432 gay men, 207 recruited at the Midsumma carnival, an annual gay and lesbian event in Melbourne and 225 through the mailing list of the Victorian AIDS Council. Analysis of the questionnaire data uncovered a complex constellation of difference in the conceptualisation and experience of gay community between the groups, particularly with regard to the content and boundaries of the category �gay community�. The research challenges practice based models of gay community attachment and proposes a more dynamic, fluid and multi-dimensional conceptualisation of gay social identity.

The objective of this research was to design semiconductor material structures for a number of different devices, including GaN metal-semiconductor-metal (MSM), InGaAs/InAlAs MSM, and InAs/GaAs quantum dot photodetectors, and to study the growth conditions for epitaxial material using molecular beam epitaxy (MBE) augmented with an rf-plasma nitrogen source. GaN was grown on a LiGaO2 substrate, which has multiple advantages over the most commonly used substrates for III-nitride growth. LiGaO2 substrates have a small lattice mismatch of approximately 1% with GaN, which leads to high-quality epitaxy film by optimization of the growth condition. The combination of nitridation, buffer, super lattice, and Ga-rich condition is the key to improving the quality of GaN film grown by MBE on LiGaO2. The first GaN MSM grown on LiGaO2 was reported, which has the dark current in the range of 10-12A. The device was then lift off and bonded on SiO2/Si wafer. The performance of the device did not degrade after integration. However, the orthorhombic crystal structure of LiGaO2 results in the unusual asymmetric strains within GaN, causing changes in the microstructure of GaN and making integration difficult. The strains within GaN grown on LiGaO2 were investigated using high resolution x-ray. It was found that the critical thickness of GaN on LGO was around 10nm, and the strains relieve with film thickness increasing. The dislocation densities were also calculated and confirmed by AFM, which can be as low as 2䥱07/cm2. Through studying of the strains with the insertion of AlGaN/GaN superlattice buffer, it was found that the strain of the epitaxial layer is dependent on the thickness and critical thickness of both epitaxy and buffer layer. For thin GaN films, Al0.12GaN superlattice buffer would relieve the strain most, and for the thicker layers, the Al0.44GaN superlattice buffer relieves the strain most. The dislocation density measurement shows that an insertion of buffer decreases dislocations significantly. Insertion of superlattice buffers does not decrease dislocation density further. The material structure of InGaAs/InAlAs was studied. The device quality was improved by optimizing the material structure. Depends on the application as optical interconnects, the optimized material structure should insure the device with high speed but reasonable responsivity. Finally, devices were fabricated that achieve speeds as high as 50-70 GHz, comparable with the commercial ultra-fast MSM. The research of quantum dots was focused on modification of the size, strains, and structures of quantum dots by annealing the spacer between quantum dot layers using As4 and P2, respectively, at different temperatures. It was found that the annealing under P2 results in surface exchange, and the annealing under As4 mostly changes dots?zes, causing the changes of energy level.

As the HIV/AIDS epidemic in the United States nears the end of its third decade, stakeholders have begun to sift through the previous experiences in prevention in order to assess progress as well as plan the next steps in this fight. The purpose of this study is aimed at understanding the factors which may affect unprotected intercourse. It is hypothesized that for men who have sex with men (MSM) there is an association between having a discussion about their HIV status and high-risk sexual behaviors. A secondary analysis was conducted using data from the National HIV Behavioral Surveillance (NHBS) System. Binary logistic regression was conducted to determine the degree of association of the dependent variables; unprotected receptive anal intercourse (URAI) with a main partner, URAI with a non-main partner, unprotected insertive anal intercourse (UIAI) with a main partner and UIAI with a non-main partner, with the independent variables of discussion of HIV status, age, race, educational attainment, number of partners and HIV status. When assessing the association between the discussion of HIV status with both URAI and UAIA it was found that discussion of HIV status was a non-significant factor. Despite the non-significant findings in relations to the hypotheses, being Black was found to be a significant predictor of URAI and UAIA with main partners in the logistic regression models. Having a positive serostatus and having 5 or more sexual partners proved to be significant risk factors for URAI and UIAI with a non-main partner, while being Black was found to be a protective factor.

Community, Attachment, Structures and the Epidemic maps some of the changes in gay men�s experience and conceptualisation of community that have occurred during the AIDS epidemic. Social identity theory has been employed to investigate the social-psychological aspects of gay identity at personal, social and community levels. The study compares three generations of gay men in Melbourne; pre- peri- and post-AIDS. As a starting point, the study employed focus groups to explore basic conceptions of gay community. In the first of two major data collection phases, 32 gay men between the ages of 18 and 40 participated in semistructured interviews of between 45 minutes and one and a half hours. The interviews explored the men�s social networks, past and present relationship to the commercial gay scene, feelings about gay organisations businesses, neighbourhoods, entertainment, aesthetics, the way they see other gay people, their thoughts about the impact of AIDS on gay communities and their aspirations for gay communities. The second phase of data collection utilised a questionnaire developed from the analysis of the interviews. The 55 item questionnaire covered demographic information, coming out history, initial experiences of the gay world, friendship networks, feelings about the institutions, people and conceptual elements of gay community, items concerning practices of gay community, the community attachment subscale from the SAPA study and items on HIV/AIDS. The questionnaire was completed by 432 gay men, 207 recruited at the Midsumma carnival, an annual gay and lesbian event in Melbourne and 225 through the mailing list of the Victorian AIDS Council. Analysis of the questionnaire data uncovered a complex constellation of difference in the conceptualisation and experience of gay community between the groups, particularly with regard to the content and boundaries of the category �gay community�. The research challenges practice based models of gay community attachment and proposes a more dynamic, fluid and multi-dimensional conceptualisation of gay social identity.