Gail E Wyatt

• University of California, Los Angeles

Background and Introduction: Race-based social rejection has been found to predict post-traumatic stress and depression symptoms, consistent with previous studies that have shown the negative mental health effects of racism, as well as social rejection in general. While racial identity has been noted as a protective factor among African Americans,...

Black and Latinx people are disproportionately impacted by HIV, COVID-19, and other syndemic health crises with similar underlying social determinants of health. Lessons learned from the HIV pandemic and COVID-19 response have been invoked to improve health equity at the systemic level in the face of other emergent health crises. However, few have...

In 2020, the COVID-19 pandemic forced unprecedented disruptions in higher education operations. While the adverse mental health effects experienced by college students due to these changes are well documented, less is known about the impact on their sexual and reproductive health (SRH), and the reciprocal relationships between SRH and mental health...

The Women-Centered Program for Women of Color, a culturally congruent sexual health intervention, was implemented in 2018 in Los Angeles County, California, according to the principles of community-based participatory research: enhancing community capacity, establishing sustainable programs, and translating research findings to community settings....

During the COVID-19 pandemic, reports of domestic violence across the United States increased from 21% to 35%. Stay-at-home orders, designed to protect the public against the spread of COVID-19, along with heightened societal stressors as a result of the global pandemic, inadvertently increased rates of illicit drug and alcohol use, job loss, and i...

This article describes the nearly half a century career of Dr. Gail E. Wyatt, PhD, and her development of novel methodologies and measures of sexual trauma, specifically the Wyatt Sex History Questionnaire and the University of California, Los Angeles, Life Adversities Screener. These approaches broke the silence around experiences of sexual violen...

It is established in the psychological literature that pre-displacement stressors, PTSD symptoms, and psychological distress are associated among internally displaced persons. However, existing studies have not demonstrated the mechanism underlying these associations. This study compared two explanatory models; one with PTSD symptoms severity expla...

Race-based trauma has been linked to multiple adverse health and mental health outcomes, including hypertension, post-traumatic stress, anxiety, and depression. While the possibility of post-traumatic growth (PTG) has been investigated following other types of trauma, relatively less work has been done on PTG following race-based trauma. In this ar...

Introduction: Substantial unmet need for mental health services (MHS) exists in the United States, with pronounced disparities among people of color. Research highlights the need to identify facilitators and barriers to MHS utilization among Black and Latinx individuals to better promote overall health. We tested an expanded model of MHS use based...

The woefully low proportion of scientists and clinicians underrepresented in medicine (UIM), including members of African-American/Black, Hispanic/Latinx, American Indian/Alaska Native or Native Hawaiian/Pacific Islander communities, is well characterized and documented. Diversity in medicine is not only just, but it improves quality and outcomes....

Background: Although there are several ways to transmit HIV, condomless sex remains the primary mode in sub-Saharan Africa, including South Africa, with KwaZulu-Natal Province being one of the epicentres of HIV infection. This study explored the use of condoms in serodiscordant couples who were exposed to an HIV-risk reduction intervention that aim...

Eban, a culturally tailored HIV risk reduction intervention for African American HIV-serodiscordant couples, has demonstrated efficacy and effectiveness in the USA, and holds promise for adaptation and implementation in other countries. In this study, Eban was adapted to suit the South African cultural context and then Eban South Africa was deliver...

Previous research highlights the need to better understand the complex relationships between factors marginalizing Black men who have sex with men and women (MSMW) living with HIV, including HIV stigma, trauma, and hegemonic masculinity. We examined associations between gender role conflict (GRC), trauma, and HIV stigma in Black MSMW living with HI...

The Coronavirus, 2019 (COVID-19) pandemic is an unparalleled crisis, yet also a unique opportunity for mental health professionals to address and prioritize mental and physical health disparities that disproportionately impact marginalized populations. Black, indigenous, and people of color have long experienced structural racism and oppression, re...

Couples-based behavioral HIV prevention interventions have demonstrated efficacy, but few are routinely available in community-based settings in the United States. The Eban intervention, designed for heterosexual African American serodiscordant couples and proven efficacious in a cluster randomized trial, was implemented in community-based HIV serv...

We utilised a cross-sectional survey design to examine the moderating roles of dimensional psychological capital (PsyCap) and pre-displacement stressors on the relationship between psychological morbidity and severity of PTSD symptoms among internally displaced (IDP) women from terrorist activity. Participants were 631 IDP women (mean age = 31.18 y...

That racial/ethnic discrimination has adverse physical and psychological consequences, including stress, anxiety, depression, and their attendant health effects, is well documented. However, the particular dimensions within the broad construct of discrimination and their role in mental health are less well understood. This study investigates the di...

Mental health clinicians and researchers must be prepared to address the unique needs of Black Americans who have been disproportionately affected by the COVID-19 pandemic. Race-conscious and culturally competent interventions that consider factors such as discrimination, distrust of health care providers, and historical and racial trauma as well a...

Objectives: African Americans face challenges in accessing services for sexually transmitted infections (STIs). From 2012-2016, the EBAN II intervention was funded by the NIH to test the effectiveness of implementing a culturally congruent, evidence-based HIV/AIDS prevention program in Los Angeles and Oakland, California. This study examined the i...

Objective: The increased life expectancy of people living with HIV has brought about an increase in serodiscordant couples, in which there is risk of HIV transmission. Therefore, interventions that promote sexual health and reduce risk are critical to develop for these couples. Given the disproportionate burden of HIV among populations of color, it...

Ethn Dis. 2020;30(2):241-246; doi:10.18865/ed.30.2.241

Antiretroviral therapy (ART) prevented premature mortality and improved the quality of life among people living with the human immunodeficiency virus (PLWH), such that now more than half of PLWH in the United States are 50 years of age and older. Increased longevity among PLWH has resulted in a significant rise in chronic, comorbid diseases. Howeve...

Cardiovascular disease (CVD) is an increasingly important cause of morbidity and mortality among people living with HIV (PLWH) now that HIV is a manageable chronic disease. Identification and treatment of comorbid medical conditions for PLWH, including CVD and its risk factors, typically lack a critical component of care: integrated care for histor...

Trauma-focused research highlights the reactions of seasoned professionals when engaging with vulnerable clients; however, less is known about the common reactions of novices engaged in trauma research, who may lack the skills to cope and interact with traumatized participants. The purpose of this study is to (a) describe common reactions experienc...

To address gaps in the cost literature by estimating the cost of delivering an evidence-based HIV risk reduction intervention for HIV-serodiscordant, heterosexual, African American couples (Eban II) and calculating the cost-effective thresholds at three participating sites. The cost, cost-saving, and cost-effectiveness thresholds for Eban II were c...

Lack of condom use by married or cohabiting couples in populations with high rates of HIV infection has become a significant public health issue. This study investigated whether an HIV risk-reduction intervention (RRI) would increase condom use when delivered to serodiscordant couples as a unit. Of the 62 couples that were screened, 30 serodiscorda...

Health inequities and disparities among various racial/ethnic minority, sexual minority, and rural populations are the focus of increasing national efforts. Three health problems disproportionately affecting these populations-HIV/AIDS, substance abuse, and trauma-deserve particular attention because of their harmful effects on health across the lif...

This article defines and discusses 6 beliefs, attitudes, and practices that can erode or undermine self-esteem and self confidence in student-scholars from underrepresented and marginalized groups in academic settings. Specifically, the beliefs and practices are reactions to implicit bias, color blindness, imposter syndrome, internalized racism, st...

This issue is a call for more culturally congruent mentorship training, support, and research on the effectiveness of mentoring strategies. The role of mentoring is fundamental to professional growth and success. Importantly, one size does not fit all. A repertoire of mentoring strategies and formats is necessary to include the talent, skills, and...

Background. South Africa (SA) has a high prevalence rate of intimate partner violence (IPV) and HIV, both of which can be exacerbated further by HIV serodiscordancy in the couple dyad. Further exploration of the discordancy sidedness in known mediating factors, such as alcohol abuse risk and post-traumatic stress (PTS), is required.Objectives. To i...

Background Cancer survivors with fatigue often experience depressive symptoms, anxiety, and pain. Previously, we reported that self-acupressure improved fatigue; however, its impact on other co-occurring symptoms and their involvement in treatment action has not been explored. Methods Changes in depressive symptoms, anxiety, and pain were examined...

Introduction: The mental health of patients with advanced cancer at the end of life is a strong contributor to suffering on the part of both the patient and family. A closer look is needed to address the complexity of psychological adaptation to provide a comfortable transition between life and death. Areas covered: This review describes patient re...

Background: Sexual transmission of HIV frequently occurs in the context of a primary relationship between two partners; however, HIV prevention interventions generally focus on individuals at risk, rather than specifying couples as a unit of change and analysis, neglecting the crucial role that partners may play in sexual behaviour. This article re...

We explored Mozambican immigrants’ lived experiences of xenophobia and discrimination in South Africa. Informants were 15 Mozambican immigrants (female = 7, male = 8) living in an informal settlement in Zandspruit, Gauteng Province. They completed open-ended written narratives on xenophobic and discriminatory experiences. Following thematic analysi...

p> Abstract Objective : To determine the coping strategies used by nurses providing maternal and perinatal care in the hospitals of the Limpopo Province, South Africa. Methods : A cross-sectional descriptive study was conducted in public hospitals (1tertiary, 2regional and 3district hospitals).A sample ofnurses andunit managers on duty at the tim...

Background Organizational context plays a critical role in the implementation of evidence-based interventions. Implementation research to date has focused largely on internal, rather than external, context. This paper presents key features of external context and their impact on implementation of Eban II, an evidence-based HIV/AIDS prevention inter...

Objective: Somatic symptoms are often reported among victims of trauma, and place a significant burden on primary care health providers. We examined the relationship between lifetime histories of trauma and adversity, including aspects not previously studied (i.e., perceived discrimination), and somatic symptoms, as well as the mediating role of p...

Provides an introduction to this special edition of Psychological Trauma. The papers included in this special section focus on aspects of trauma and the effects of trauma in a cultural context that pertains to the way of life in South Africa. These articles highlight the complexities of the effects of trauma and call for tailored interventions to a...

Objective: Sexual assaults against women are a global health crisis, with alarmingly high rates in South Africa. However, we know very little about the circumstances and the aftermath of these experiences. Further, there is limited information about how factors specific to the rape (e.g., fighting back) versus those that are specific to the indivi...

Family and friends are important resources for patients during cancer treatment and warrant an expanded review of not only what they contribute to patient care but also the support they need and the personal consequences of caregiving. A review of 14 randomized controlled trials published between 2009 and 2016 was completed utilizing the Preferred...

Importance Fatigue is a common and debilitating late-term effect of breast cancer that is associated with poor sleep and decreased quality of life, yet therapies remain limited. Acupressure has reduced fatigue in previous small studies, but rigorous clinical trials are needed. Objectives To investigate if 6 weeks of 2 types of self-administered ac...

Targeting couples is a promising behavioral HIV risk-reduction strategy, but the mechanisms underlying the effects of such interventions are unknown. We report secondary analyses testing whether Social-Cognitive-Theory variables mediated the Eban HIV-risk-reduction intervention's effects on condom-use outcomes. In a multisite randomized controlled...

Introduction and aim: Given the high prevalence and detrimental consequences of alcohol or other drug (AOD) use in low- and middle-income countries, a screening tool for early detection in health care, including emergency care, is critical. We set out to validate the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for the South...

We examined African American women's experiences of communication with their male intimate partners a couple of hours before and after an incident of unwanted sex. We also examined women's experiences of disclosure following an incident of unwanted sex. Semi-structured qualitative interviews were conducted with a community-based sample of sexually...

Context: Lower urinary tract symptoms (LUTS) affect 75-80% of men undergoing radiation therapy (RT) for prostate cancer. Objectives: To determine the safety, maximum tolerated dose (MTD) and preliminary efficacy of Serenoa repens commonly known as saw palmetto (SP) for management of LUTS during RT for prostate cancer. Methods: The dose finding...

Background: Persistent fatigue is a common and debilitating symptom in breast cancer survivors (BCS), yet treatments remain limited. The purpose of this study was to examine the effect of two types of self-administered acupressure on fatigue versus usual care in BCS. Methods: This was a 10-week randomized trial that enrolled adult female BCS (stage...

This study investigated the prevalence and levels of burnout, compassion fatigue and compassion satisfaction among nurses with exposure to maternal and perinatal deaths. A convenience sample of 83 nurses was selected for participation from six hospitals in Limpopo province, South Africa, comprising 98% females with an age range of 21 to 62 years, a...

Healing Our Women (HOW) is a group-level HIV risk-reduction intervention developed to address the role of prior sexual victimization in HIV risk and protective behaviors among HIV-positive women of color. This article describes the process of adapting HOW for transgender women of color in New York City in accordance with CDC guidance for the adapta...

Background: Termination of pregnancy (TOP) remains a controversial issue, regardless of legislation. Access to services as well as psychological effects may vary across the world. Objectives and methods: To better understand the psychological effects of TOP, this study describes the circumstances of 102 women who underwent a TOP from two socioec...

Panel overview abstract Implementation research is the scientific study of methods that promote systematic uptake of research findings and other evidence-based practices into routine practice, thereby improving the quality and effectiveness of health services. As the field has progressed over the past decades , substantial advances continue in the...

Researchers in the fields of implementation and improvement science have increasingly recognized the importance of context in understanding implementation processes and outcomes (Damschroder et al, 2009; Taylor et al, 2011; Kaplan et al, 2012). To date much of the attention in conceptualizing and measuring contextual factors has targeted internal c...

Common mental disorders are highly prevalent in emergency centre (EC) patients, yet few brief screening tools have been validated for low- and middle-income country (LMIC) ECs. This study explored the psychometric properties of the SRQ-20 screening tool in South African ECs using the Mini Neuropsychiatric Interview (MINI) as the gold standard compa...

Purpose: As home-based care continues to be a growing trend in health care, involvement of friend and family caregivers in the management of illness becomes essential. However, before nurses can prepare caregivers to engage in various types of care, an evidence base needs to be established via randomized controlled trials (RCTs). Research suggests...

Multiple pathways link gender-based violence (GBV) to HIV and other sexually transmitted infections among women and girls who use or inject drugs. The aim of this article is to synthesize global literature that examines associations among the synergistic epidemics of substance abuse, violence, and HIV/AIDS, known as the SAVA syndemic. It also aims...

The high burden of exposure to chronic life adversities and trauma is quite prevalent, but assessment of this risk burden is uncommon in primary care settings. This calls for a brief, multiple dimensional mental health risk screening tool in primary care settings. We aimed to develop such a screening tool named the University of California, Los Ang...

This study examined the utility of a lifetime cumulative adversities and trauma model in predicting the severity of mental health symptoms of depression, anxiety, and posttraumatic stress disorder. We also tested whether ethnicity and gender moderate the effects of this stress exposure construct on mental health using multigroup structural equation...

Poster presentation at the 40th Annual ONS Congress, Orlando, FLA. [Abstract]. Oncology Nursing Forum, 42 (2), E213.

The contentious issue of termination of pregnancy (TOP) is fraught with challenges given the diverse ethical dilemmas that exist within a given sociocultural context. This research study, drawn from a larger study of 102 women, focuses on the qualitative responses of 22 women from diverse socioeconomic backgrounds in Johannesburg, South Africa. Con...

Little is known about the prevalence and predictors of mental disorders amongst injured emergency centre (EC) patients in low- and middle-income countries. Patients presenting with either an intentional or unintentional injury were recruited (n=200). Mental health, injury and psychological trauma histories were assessed. Descriptive statistics and...

Background: The HIV/AIDS epidemic continues to disproportionately affect African American communities in the US, particularly those located in urban areas. Despite the fact that HIV is often transmitted from one sexual partner to another, most HIV prevention interventions have focused only on individuals, rather than couples. This five-year study...

Objective: Little research exists identifying risk factors for posttraumatic stress symptoms (PTSS) among men with histories of childhood sexual abuse (CSA) who have been exposed to intimate partner violence (IPV). Methods: One hundred and fifty African American, Latino and non-Latino White men with histories of CSA participated in this study....

Violence against women is a global public health problem. Exposure to intimate partner violence (IPV) during pregnancy has been associated with a number of adverse maternal and fetal outcomes, including delivery of a low birthweight (LBW) infant. However, there is a paucity of data from low-middle income countries (LMIC). We examined the associatio...

Background: Gender-based violence is a challenge in South Africa, despite available interventions. Caring for the survivors of both forms of violence is critical for ensuring their speedy recovery. Objectives: To compare the effects of trauma on female survivors of sexual assault versus those experienced by survivors of physical assault by their i...

Mental illness accounts directly for 14% of the global burden of disease and significantly more indirectly, and recent reports recognise the need to expand and improve mental health delivery on a global basis, especially in low and middle income countries. This text defines an approach to mental healthcare focused on the provision of evidence-based...

Adult men of different ethnic backgrounds who experienced childhood sexual abuse (CSA) may vary in their reports of the psychological and behavioural impact of CSA on their lives. Empirical studies rarely examine the impact of race/ethnicity or cultural context on the psychological and behavioural struggles of adult male CSA survivors. This study u...

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of psychosocial interventions for preventing reinjury due to interpersonal violence in injured emergency centre patients.

Zimbabwean refugees can be considered a vulnerable group in terms of how they are displaced with many of them having lived through hardships on their way to South Africa and other African countries. Zimbabwe is known to be Africa's most extraordinary producer of migrants and the biggest producer of refugees in Southern Africa. It is estimated that...

Over the years, more than 3.4 million Zimbabweans (a quarter of the country's population) have fled the country to other countries with South Africa as the main popular destination. In South Africa, they become a vulnerable group with the plausibility of suffering trauma and PTSS or PTSD due to xenophobic attacks and resentment. How males and femal...

Exposure to traumatic events may precipitate suicidal ideation. Once an individual is diagnosed with PTSD, a suicide risk assessment often follows. This study explores how PTSD symptom criteria correlate with suicidal ideation in a sample of police officers. While the psychometric measures of PTSD often mirror the DSM-IV-TR criteria, focusing on ex...

The Healing Our Women Program, an 11-week integrated trauma/HIV intervention designed for HIV-positive women with child sexual abuse histories, has been found to reduce psychological distress in treatment groups compared with wait-list controls (Chin, Wyatt, Carmona, Loeb, & Myers, 2004; Wyatt et al., 2011). This study examines the characteristics...

Objectives: HIV transmission risk is high among men who have sex with men and women (MSMW), and it is further heightened by a history of childhood sexual abuse (CSA) and current traumatic stress or depression. Yet, traumatic stress is rarely addressed in HIV interventions. We tested a stress-focused sexual risk reduction intervention for African A...

This article articulates a contextualized understanding of gender and ethnicity as interacting social determinants of HIV risk and acquisition, with special focus on African Americans and Hispanics/Latinos—2 ethnic groups currently at most risk for HIV/AIDS acquisition in the United States. First, sex and gender are defined. Second, a conceptual mo...

This study presents the results of a secondary analysis of data collected during a trial of reflexology that aimed to improve health-related quality of life (HRQOL) among women with advanced breast cancer in treatment. A comparison of HRQOL (functioning, symptoms, spirituality) of those with (n = 298) and without (n = 87) distant metastasis is pres...

Abstract Modest or even occasional nonadherence to combined antiretroviral therapy (cART) can result in adverse clinical outcomes. African Americans demonstrate lower rates of adherence than Caucasians or Latinos. Identifying factors that influence medication adherence among African Americans is a critical step toward reducing HIV/AIDS disease prog...

Childhood sexual abuse (CSA), adult sexual abuse (ASA) and intimate partner violence (IVP) are documented risk factors for HIV infection and are often implicated in the presentation of mental health disorders in both males and females, including those who are vulnerable to HIV-infection (African-Americans; trauma survivors). As such, these issues m...

Background: Zimbabweans are immigrating to South Africa with a commonly cited reason being economic opportunities. Prospects of finding employment may be a significant reason to leave behind family, friends, and community, sources that buffer and offer social support against life’s challenges. Currently, there is a dearth of research examining the...

Women with histories of child sexual abuse (CSA) are more likely than those without such experiences to report a variety of negative sexual outcomes. This study examines the explanatory power of a CSA summed composite versus dichotomous (presence/absence) measurement in predicting a comprehensive negative sexual behavior outcome. Study participants...

Experiences of past and current gender-based violence are common among HIV-positive women in the United States, who are predominantly from ethnic minority groups. However, culturally congruent, feasible interventions for HIV-positive women who have experienced past and/or current violence are not widely available. The Office on Women's Health Gende...

This paper presents a study of African American women's sexual revictimization experiences in the context of historical and sociocultural factors. African American and White American women have been socialized differently about the history of race in America and stereotypes about who meets the societal-criteria's for rape victims today. In order to...

This study examined the associations of prenatal psychosocial factors, including depressive symptoms, post-traumatic stress disorder symptoms, trauma exposure including intimate partner violence, perceived stress, and social support, with perceived postpartum health status. Low-income Latinas (N = 203) were recruited from two health plans within th...

Reflexology is a common choice of women with breast cancer as supportive care during treatment. It involves stimulation of specific locations of the feet called reflexes using a specialised walking motion with the thumb of the reflexologist. Reflexology has shown potential for the successful management of cancer and treatment-related symptoms and i...

Objective: To determine the extent to which current United States based human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) prevention and risk reduction interventions address and include aspects of cultural beliefs in definitions, curricula, measures and related theories that may contradict current safer sex messages. Met...

A history of childhood sexual abuse (CSA) has been associated with adult depression, but data on abuse severity and disclosure are scant, particularly among low-income ethnic minorities. CSA often co-occurs with other adversities, which also increase the risk of depression. This study examined the peritrauma variable of abuse severity and the postt...

The high morbidity and mortality in African Americans associated with behavior-linked chronic diseases are well documented. We tested the efficacy of an intervention to increase multiple health-related behaviors in African Americans. In a multisite cluster-randomized controlled trial, groups of African American human immunodeficiency virus (HIV)-se...

This study investigated the association between cumulative exposure to multiple traumatic events and psychological distress, as mediated by problematic substance use and impaired psychosocial resources. A sample of HIV-positive and HIV-negative women were assessed for a history of childhood and adult sexual abuse and non-sexual trauma as predictors...

Clinical trials involving technologically involved novel treatments such as gene therapy delivered through hematopoietic stem cells as human immunodeficiency virus (HIV) treatment will need to recruit ethnically diverse patients to ensure the acceptance among broad groups of individuals and generalizability of research findings. Five focus groups o...

HIV/AIDS continues to be a devastating epidemic with African American communities carrying the brunt of the impact. Despite extensive biobehavioral research, current strategies have not resulted in significantly decreasing HIV/AIDS cases among African Americans. The next generation of HIV prevention and risk reduction interventions must move beyond...

This paper reports baseline behavioral and biological data collected from a cohort of 535 African American HIV serodiscordant couples enrolled in the Eban study across four urban metro areas. Data were collected on (1) the prevalence of risky sexual behaviors that occur within a couple and with concurrent sexual partners, (2) the STD prevalence for...

Growing evidence suggests that drug and alcohol use are fueling the heterosexual transmission of HIV among African Americans. This study aims to examine the relative contribution of drug and alcohol use of male and female partners to risks of heterosexual transmission of HIV among 535 African American HIV serodiscordant couples (N = 1,070 participa...