Diane Binson

University of California, San Francisco, San Francisco, California, United States

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Publications (18)20.78 Total impact

  • Michelle Teti · Allison Kabel · Diane Binson
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    ABSTRACT: Background Using the visual arts to inspire creativity, insight, and healing are common therapies for people with critical illness. HIV/AIDS is a life-long and serious illness that requires constant management, yet the use of art to improve the lives of people with HIV (PWH) is under-utilized. Thus, we developed and explored the impact of a pilot photo-story project on the health and well-being of PWH. Methods Participants took part in the project in small groups of four to eight. Project components included a photography tutorial, three group photo-sharing and discussion sessions, and a community photo exhibit. To assess project impact, we conducted post-project individual interviews and analyzed transcripts of group and individual sessions and over 200 participant photographs using strategies of theme analysis. Results Participants included eight men and 20 women living with HIV in urban areas of the Midwest, U.S. Participants indicated the project gave them a “muse” and “unleashed the artist in them,” which helped them think about HIV and their life in new ways. Key themes about how creating and sharing art affected participants were: enhanced inspiration and insight, acquiring a new artistic “hobby,” seeing beauty in their surroundings, and most importantly, establishing a creative way to express their strengths and resilience. Photos were varied and included images of nature, spirituality, and self-portraits. Conclusions Arts-based interventions can inspire creativity, and help PWH see their lives differently. Creativity and insight can help PWH build and express resilience. Offering photography as form of expression is a potentially simple way to foster strength and consequently, improve the lives of PWH.
    142nd APHA Annual Meeting and Exposition 2014; 11/2014
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    ABSTRACT: Background: Art-based interventions can improve well-being, particularly among people with life-changing illnesses. We conducted a pilot photo-story intervention with gay-identified men with HIV in the Midwest USA to help men express and manage HIV stigma; and assess the feasibility of arts-based interventions. Methods: Eight men took pictures, participated in three group and one individual discussion session, and planned and attended two public photograph exhibits. Theme and narrative analysis identified key stigma and feasibility themes in qualitative textual and visual data. Results: Men's images and discussions focused on three aspects of HIV stigma: (1) ignorance, (2) difficult disclosures and (3) isolation. Photo-stories facilitated men's ability to manage stigma by promoting (1) self-discovery and (2) social support. Conclusions: Participants' stigma experiences were significant. Stigma intervention solutions are needed at individual, relational, community and social levels. Art-based interventions such as photo-stories are promising strategies to identify and address stigma at all levels.
    Arts & Health 05/2014; DOI:10.1080/17533015.2014.971830
  • Michelle Teti · Diane Binson
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    ABSTRACT: Introduction: Many women living with HIV/AIDS (WLH/A) face significant psychological stressors. Novel strategies are needed to help women process these experiences and improve mental health outcomes. We conducted a pilot photovoice intervention called Picturing New Possibilities (PNP) that provided WLH/A an opportunity to identify, discuss and address their mental health challenges and strengths through photography. Methods: We conducted PNP with 30 WLH/A from three U. S. cities. Participants photographed their experiences, participated in three group discussions, and led a community exhibit of their photos. We explored the impact of the project through group and follow-up interviews. We analyzed transcripts of group and individual interviews for key themes using strategies of thematic and narrative analysis. Results: Women reported that PNP helped them to: 1. Identify their feelings about living with HIV; 2. Manage anxiety and depression; and 3 Process traumatic experiences. For example, participants said that the project helped them to express feelings and hurts behind this disease; brought me out of my depression; and taught me how to grieve [traumas]. Pictures captured strength, support, and hope; and included powerful self-portraits and images of spirituality, friends, pets, and the beauty of nature. Conclusions: Our preliminary findings support the use of photovoice to enhance mental health among WLH/A. The process offers women a creative way to tell their story, explore their emotions, share their feelings, and learn from others. The images give women a way to create, identify, and document supportive and positive aspects of their lives. The camera fosters both pleasure and skillfulness, which builds women's confidence.
    141st APHA Annual Meeting and Exposition 2013; 11/2013
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    ABSTRACT: Poor and racial/ethnic minority women comprise the majority of women living with HIV (WLH) in the United States. Race, gender, class, and HIV-based stigmas and inequities limit women's powers over their health and compromise their quality of life. To help WLH counter this powerlessness, we implemented a Photovoice project, called Picturing New Possibilities (PNP), and explored how women experienced empowerment through Photovoice. PNP participants (n = 30) photographed their life experiences, attended 3 group discussions and a community exhibit of their photos, and completed a follow-up interview. We used strategies of Grounded Theory to identify key empowerment themes. Participants described empowerment through enhanced self-esteem, self-confidence, critical thinking skills, and control. Our findings suggest that Photovoice is an important tool for WLH. It offers women a way to access internal strengths and use these resources to improve their quality of life and health.
    The Journal of the Association of Nurses in AIDS Care: JANAC 09/2013; 24(6). DOI:10.1016/j.jana.2013.05.001 · 1.23 Impact Factor
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    ABSTRACT: Objective. Effectively addressing health disparities experienced by sexual minority populations requires high-quality official data on sexual orientation. We developed a conceptual framework of sexual orientation to improve the quality of sexual orientation data in New Zealand's Official Statistics System. Methods. We reviewed conceptual and methodological literature, culminating in a draft framework. To improve the framework, we held focus groups and key-informant interviews with sexual minority stakeholders and producers and consumers of official statistics. An advisory board of experts provided additional guidance. Results. The framework proposes working definitions of the sexual orientation topic and measurement concepts, describes dimensions of the measurement concepts, discusses variables framing the measurement concepts, and outlines conceptual grey areas. Conclusion. The framework proposes standard definitions and concepts for the collection of official sexual orientation data in New Zealand. It presents a model for producers of official statistics in other countries, who wish to improve the quality of health data on their citizens.
    Journal of Environmental and Public Health 06/2013; 2013:473451. DOI:10.1155/2013/473451
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    ABSTRACT: Many HIV prevention interventions have been launched in gay bathhouses and sex clubs since the onset of the AIDS epidemic, such as condom distribution and HIV testing. Perhaps none of these are as intrusive to the venue's environment as what is called "monitoring," which involves staff, during every shift, repeatedly walking throughout the public areas of a bathhouse to check on patrons' sexual behavior. Yet, monitoring has received little evaluation. Between 2002 and 2004, we conducted qualitative interviews with venue managers, staff and patrons in New York City, Los Angeles, and the San Francisco Bay Area. An analysis found that monitoring was influenced by the kinds of space available for sex, suggesting three approaches to monitoring: 1) monitoring all sex in clubs that only had public areas where men had sex ; 2) monitoring some sex in clubs with private rooms for sex; and 3) no monitoring of sex, regardless of the kinds of space for sex. This paper explores each approach as described by club managers, staff, and patrons to understand the potential effectiveness of monitoring as an HIV prevention intervention.
    Sexuality Research and Social Policy Journal of NSRC 06/2013; 10(2):77-86. DOI:10.1007/s13178-013-0112-y
  • Michelle Teti · Diane Binson
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    ABSTRACT: Introduction: Many women with HIV/AIDS (WLH/A) in the U.S. are living longer, but HIV/AIDS is still a stigmatized, lifelong illness. Accordingly, an HIV/AIDS diagnosis can diminish a woman's sense of identity and purpose. WLH/A may benefit from opportunities to redefine themselves and confront their own and other's uncertainties. We conducted a photovoice project with WLH/A that provided them an opportunity to explore themselves and their life experiences. Methods: Photovoice is a community-based participatory process that utilizes photography to engage marginalized groups in research and change. We conducted five photovoice projects with 30 WLH/A from three U. S. cities. Participants photographed their life experiences; and attended three group discussions followed by a community exhibit of their photos. We explored the impact of the project through one-on-one follow-up interviews. We analyzed transcripts of group discussions and interviews for key themes using strategies of thematic and narrative analysis. Results: Evidence of positive transformations were abundant in women's photos and narratives. Six key themes of change were most prominent, including visually expressed transitions from: sickness to health; denial to acceptance of life with HIV/AIDS; despondence to full of life; shame to pride in oneself; aimlessness to purposeful; and victim to survivor. Conclusions: Photovoice can be an important way for disenfranchised WLH/A to make meaning out of their life experiences. The camera provided the tool for women to visually express and redefine themselves. The opportunity to re-present themselves through photos and share their transformations may have important implications for women's quality of life and well-being.
    140st APHA Annual Meeting and Exposition 2012; 10/2012
  • Michelle Teti · Diane Binson
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    ABSTRACT: Introduction: HIV/AIDS disproportionately affects poor and racial/ethnic minority women. Race, gender, class, and HIV/AIDS-based stigmas and inequities limit women's power over their health decisions and quality of life. To help facilitate empowerment of women living with HIV/AIDS (WLH/A), we conducted a photovoice project. Photovoice is a community-based participatory research method that utilizes photography to engage underrepresented groups in research and community change. Methods: Thirty WLH/A from three U. S. cities took part in the project. Participants photographed their life experiences; and attended three group discussions followed by a community exhibit of their photos. Through one-on-one follow-up interviews we explored the impact of the project on participants. We analyzed transcripts of group discussions and interviews for key themes using strategies of thematic and narrative analysis. Results: The majority of participants were African American (73%). Their mean age was 45 years. Participants' narratives revealed how the project facilitated their enhanced self-worth; confidence in their abilities and strengths; increased control over daily problems and HIV/AIDS; critical thinking skills to approach problems in new ways; and social action to address community-level challenges such as violence, homelessness, and AIDS-stigma. Conclusion: Photovoice is an effective means to facilitate empowerment and change among WLH/A. Photography and critical group dialogue facilitated women's creativity as they embraced new ways to understand and gain control over their challenges. Individual empowerment experiences translated into social action. Disenfranchised women living with HIV/AIDS solved problems in their own lives and also became leaders in efforts to improve the overall well-being of their communities.
    140st APHA Annual Meeting and Exposition 2012; 10/2012
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    ABSTRACT: photovoice is a method in which participants use photography to identify, express, and disseminate their experiences. We conducted photovoice projects with women living with HIV/AIDS (N=21) to explore opportunities and challenges associated with the method. Photovoice provided a means to achieve two key principles of ethical public health practice: It gives participants opportunities to define their health priorities, and facilitates participant empowerment. Ethical challenges that were encountered related to exposing, through photographs, one's identity as living with HIV/AIDS, illicit activities, and other people. We discuss lessons learned for future practice to maximize the ethical opportunities and manage the challenges associated with using photovoice as an HIV-related CBPR strategy.
    Journal of Empirical Research on Human Research Ethics 10/2012; 7(4):34-43. DOI:10.1525/jer.2012.7.4.34 · 1.22 Impact Factor
  • 08/2012; 3(2):163-182. DOI:10.1386/jaah.3.2.163_1
  • Michelle Teti · Diane Binson
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    ABSTRACT: Background: Health promotion and prevention strategies for women living with HIV/AIDS (WLH/A) are critical to improve women's quality of life and prevent HIV transmission. Opportunities for WLH/A to define and express their health priorities are often not considered, yet knowing WLH/A's perspective is essential to effective service provisions. We conducted a photovoice project to engage WLH/A about their health experiences, and harness the power of women's photo-narratives to inform participant-driven health promotion and prevention strategies for WLH/A. Methods: We recruited WLH/A from two AIDS service agencies in St. Louis, Missouri. Participants (N=13) photographed their experiences and health and prevention needs; and attended a training session, two photo discussion sessions, and a community exhibit of their photos. We analyzed transcripts of discussion sessions for key themes and narratives. Results: The participants were African American (92%). Their mean age was 42 years. Our analysis revealed that women's photo-narratives served six key functions: document health/social challenges; process trauma; depict visually the journey from sickness to living healthily with HIV/AIDS; express hopefulness; acknowledge social support; and promote action and advocacy to solve problems. Conclusions: Photovoice is a powerful strategy to motivate dialogue among WLH/A, and to identify women's needs. Photo-narratives have implications for health promotion and prevention strategies. The findings suggest that services for WLH/A should focus holistically on women's lives and needs, not just on HIV/AIDS; help women recover from trauma; acknowledge women's ability to transform from despair to health; build and nurture social support; and recognize WLH/A as healthy, powerful, and capable.
    139st APHA Annual Meeting and Exposition 2011; 11/2011
  • 12/2001: pages 133-162;
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    ABSTRACT: This report investigates differences in risk behaviors among men who have sex with men (MSM) who went to gay bathhouses, public cruising areas, or both. We used a probability sample of MSM residing in 4 US cities (n = 2,881). Men who used party drugs and had unprotected anal intercourse with nonprimary partners were more likely to go to sex venues than men who did not. Among attendees, MSM who went to public cruising areas only were least likely, and those who went to both public cruising areas and bathhouses were most likely to report risky sex in public settings. Distinguishing between sex venues previously treated as a single construct revealed a significant association between pattern of venue use and sexual risk. Targeting HIV prevention in the bathhouses would reach the segment of men at greatest risk for HIV transmission.
    American Journal of Public Health 10/2001; 91(9):1482-6. DOI:10.2105/AJPH.91.9.1482 · 4.23 Impact Factor
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    ABSTRACT: Based on national level surveys, we examined data relevant to the United States' overall effort to prevent the spread of HIV among heterosexual adults. We examined changes in condom use among at-risk heterosexuals over the past decade. The observed increases over time in condom use across all heterosexual at-risk population segments are consistent with the observed (declines) trends in HIV and syphilis in the 1990s. These results and findings from prior studies suggest that U.S. efforts to facilitate condom use and contain HIV and related sexually transmitted disease (STD)-cofactors among adult at risk heterosexuals was succeeding over most of the 1990s. The absence of national level behavioral trend data after 1996, and the ambiguities of HIV spread suggest some caution in projecting trends into this century. National and local efforts need to be directed at sustaining behavioral change and conducting more rigorous studies on population trends in HIV/STD-related behaviors/pathogens.
    JAIDS Journal of Acquired Immune Deficiency Syndromes 07/2001; 27(2):176-82. DOI:10.1097/00042560-200106010-00013 · 4.39 Impact Factor
  • AIDS 04/2000; 14(5):625-6. DOI:10.1097/00002030-200003310-00024 · 6.56 Impact Factor
  • Diane Binson · Lance Pollack · Joseph A. Catania
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    ABSTRACT: Women in midlife and older represent over 25% of all women with AIDS and 4% of all reported AIDS cases in the United States. We present prevalence estimates and demographic correlates of AIDS-related risk behavior and safer sex practices among women in midlife and older from the National AIDS Behavioral Surveys (NABS). Data are of women aged 40 to 75 in the (a) NABS 1 national sample (n = 887), (b) NABS 1 urban sample (n = 2,111), and (c) NABS 2 national sample (n = 624). Data from the baseline survey (NABS 1) revealed that approximately 8% or 4.5 million women aged 40 to 75 engaged in behaviors that might expose them to HIV. Data from the follow-up survey (NABS 2) indicated that the proportion of women who reported a risk factor remained at about 8%. Overall safer sex practices among older women who reported sexual risk behaviors were minimal. Between 90% and 100% had not used condoms in the previous 6 months. Moreover, almost 90% of the women who reported a risk behavior did not perceive themselves to be at risk.
    Health Care For Women International 07/1997; 18(4):343-54. DOI:10.1080/07399339709516289 · 0.63 Impact Factor
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    ABSTRACT: We examined risk factors for HIV and changes in condom use among heterosexual adults (N = 987) over three waves of data from the AIDS in Multi‐Ethnic Neighborhoods (AMEN) cohort survey (1988–89, 1989–90, 1991–92). We found that respondents had maintained increases in condom use reported at Wave 2, but the overall picture is one of condom use having plateaued (and possibly decreased; see sales data). The self‐report condom use data parallel national data on condom sales for 1990 to 1992. Changes in condom use between Waves 2 and 3 were unrelated to social class, race / ethnicity, and age. Men and people without primary sexual partners were the most likely to report gains in condom use from Wave 2 to 3. At‐risk people did not show changes in condom use with primary sexual partners. People with multiple sexual partners at Waves 2 and 3 also did not change in condom use. However, people who acquired risk by Wave 3 showed significant increases in occasional condom use. The results call for renewed efforts to facilitate condom use (and HIV testing) among the chronically at risk and those at‐risk individuals who enter “monogamous” relationships.
    The Journal of Sex Research 01/1995; 32(3):193-200. DOI:10.1080/00224499509551790 · 2.53 Impact Factor
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    ABSTRACT: Data from 3,482 women aged 18-49 living in 23 urban areas of the United States who participated in the 1990-1991 National AIDS Behavioral Surveys show that in the preceding year, approximately 15% engaged in sexual behavior that might expose them to the human immunodeficiency virus (HIV). Risk behaviors include having multiple sexual partners, having a risky main sexual partner or having both multiple partners and a risky main partner. An additional 17% of women with no other risk factor report that they do not know their main partner's HIV risk status. Predictors of risk factors vary by ethnicity, and having multiple partners and having a risky main partner appear to have distinct sets of predictors. Single women are more likely than others to have multiple partners, and among white women, those with more than 12 years of education are more likely to have multiple partners. Among blacks and Hispanics, younger women are more likely than older women to have multiple partners. Among Hispanic women, married respondents and those with more than 12 years of education are more likely than others to have a risky main sexual partner; the latter pattern is reversed among white women, however, with those having less than 12 years of education being more likely to have a risky main sexual partner. In general, women with a risky main partner are the least likely to use condoms consistently.
    Family Planning Perspectives 11/1993; 25(6):252. DOI:10.2307/2136141