Date of Award

Fall 1-10-2020

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Counseling and Psychological Services

First Advisor

Cirleen DeBlaere, PhD

Second Advisor

Don Davis, PhD

Third Advisor

Brian Dew, PhD

Fourth Advisor

Melissa Zeligman, PhD

Abstract

By 1991, the Human Immunodeficiency Virus (HIV) had claimed more than 250,000 lives in the United States (US; Chadwick, Zelaya & DeBlaere, 2017). That same year, the first clinical trials began to test the effectiveness of Antiretroviral Treatment (ART) to combat the virus (HIV.gov, 2017). By 1995, HIV/AIDS became the leading cause of death among Americans age 25-44 (Zuninga et al., 2008), becoming a modern epidemic of unprecedented proportions, particularly among sexual minority men. Over time, treatments for HIV improved in their scope and effectiveness, leading to our modern conceptualization of HIV as a chronic illness, rather than a terminal disease. Pre-exposure prophylaxis (PrEP) is a recently developed primary medical prevention method for HIV. Although clinical trials have demonstrated promising results in terms of efficacy, little is known regarding the attitudes of individuals most likely to benefit from PrEP treatment (e.g. sexual minority men). As such, the proposed study aims to address this gap in the research literature by contributing a psychological perspective on HIV and PrEP. Specifically, Chapter 1 provides a systemic literature review of the flagship psychological journals associated with subfields within the discipline (e.g. counseling psychology, men and masculinity issues, sexual orientation diversity) uniquely suited to contribute expertise relevant to the HIV epidemic. Chapter 2 proposes to develop a scale measuring the psychosocial determinants of PrEP utilization. Based on the extant literature, four factors are proposed for the PrEP Determinants (PrEP-D) scale, including knowledge about PrEP, stigma, treatment attributes, and perceived effectiveness. Results of exploratory and confirmatory factor analyses using data collected from a sample of sexual minority men suggest the presence of four factors in the PrEP-D scale, consistent with the themes identified in the literature. The study also provides initial evidence of internal consistency, reliability, and construct validity.

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