Michael D. Knox's research while affiliated with University of South Florida and other places

Publications (16)

Article
HIV risk factors were assessed among 120 persons in treatment for serious mental illness. Although subjects had good general knowledge regarding HIV, many engaged in high risk behaviors. Condom use was infrequent among those who had multiple sexual partners, and sharing needles was common for those who used i.v. drugs. Clearly, factual knowledge ab...
Article
There is a critical need for trained HIV mental health specialists who possess the knowledge and attitudes necessary to meet the challenges of the HIV epidemic. A model for an intensive and experimental continuing education tutorial is briefly described, and evaluative data are presented. Upon completion of the three-day workshop, participants show...
Article
The growing mental health needs that are related to HIV are immense and diverse. The HIV mental health spectrum is a model that identifies and characterizes populations in need of HIV-related services which can be offered by Community Mental Health Centers. The spectrum describes the specialized service requirements for each of these populations, t...
Article
This paper documents the changing need for early detection of HIV infection and proposes a role for community mental health centers (CMHCs). Ignorance of HIV infection status can result in greater risk of medical complications and denies the individual the opportunity to take the steps necessary to prolong life and prevent further transmission of t...
Article
This paper documents the changing need for early detection of human immunodeficiency virus (HIV) infection and proposes a role for community mental health centers (CMHCs). Ignorance of HIV infection status can result in greater risk of medical complications and denies the individual the opportunity to take the steps necessary to prolong life and pr...
Article
Mental health and substance abuse treatment staff completed a set of measures assessing their attitudes, knowledge, and beliefs concerning AIDS. Results indicated that while most staff were aware of basic information about the disease, approximately one-third were not aware of the neuropsychological and psycho-behavioural concomitants of the disord...
Article
HIV disease is an emerging community mental health concern. The need for specialized training to help community mental health professionals develop comprehensive knowledge and skills to serve this new population of clients is evident. The HIV clinical tutorial model is an innovative approach to continuing education characterized by an experiential...
Article
This paper documents the changing need for early detection of human immunodeficiency virus (HIV) infection and proposes a role for community mental health centers (CMHCs). Ignorance of HIV infection status can result in greater risk of medical complications and denies the individual the opportunity to take the steps necessary to prolong life and pr...
Article
Administrators of publicly-funded mental health and substance abuse programs described their agencies' activities, policy development, the administrative impediments, and training needs related to caring for HIV-infected clients. Almost all have served HIV-infected clients and admit clients to their programs regardless of HIV status. The administra...
Article
Mental Health concomitants of the AIDS crisis are reviewed along with recommendations for a community mental health response. Proposed interventions range from traditional clinical services to support groups, case management, day treatment, training of caregivers, outreach, consultation, and community education. It is recommended that, at the very...
Article
Mental health care providers completed a set of measures assessing their attitudes, knowledge, and beliefs concerning AIDS. Those surveyed were aware of the main transmission routes but were excessively concerned about casual contact. Most indicated that they are not competent to deal with AIDS patients and would prefer not to care for them. The ma...
Article
Administrators of publicly-funded mental health and substance abuse programs described their agencies' activities, policy development, the administrative impediments, and training needs related to caring for HIV-infected clients. Almost all have served HIV-infected clients and admit clients to their programs regardless of HIV status. The administra...
Article
This paper examines the factors contributing to reduced psychiatric participation in community mental health centers and state hospitals. Important considerations include level of compensation, other incentives, experiences during medical education, affiliation with medical settings, and licensing requirements. Suggestions are offered which may imp...

Citations

... HIV stigma may be more severe and more powerful than other forms of stigma because it is so intricately related to social ostracism, personal vulnerability, death, fear of contagion, attribution of blame, and discrimination by association (Pryor and Reeder 1993). HIV-related stigma has been documented in the United States among the general public (Borcher and Rickabaugh 1795; Herek and Capitanio 1992, 1993; St. Lawrence et al. 1990; Blendon and Donelan 1988), physicians (Sherer and Goldberg 1994; Kelly et al. 1987), nurses (Peate 1775; Eliason 1993; Hall 1972; Siminoff, Erlen, and Lidz 1971; Denker 1790; Faugier and Wright 1790; Kelly et al. 1988), mental health practitioners (Knox and Clark 1993 ), and social workers (National Association of Social Workers 1995; Wiener and Siege1 1990). HIV-infected persons have reported that HIV-related stigma has negative effects socially (such as isolation because they are reluctant to ask for formal and informal support) and psychologically (such as lowered self-esteem and self-efficacy) (Moneyham et al. 1995; Laryea and Gien 1993; Macks 1993; S T I G M A . ...
... This was particularly prevalent in much of the HIV/AIDS research where not only actual fluid exchange, but the possibility of fluid exchange, was associated with disease transmission. Thus, respondents consistently overestimated HIV risks associated with not only saliva transferred during kissing, but also cleaning vomit, being spat on, sharing a toothbrush, nasal/sneeze droplets, urine on toilet seats, sweaty hands, and manual sex (Crawford et al., 1990;Dow and Knox, 1991;Lamport and Andre, 1993;LeBlanc, 1993;Guttman et al., 1998;Hoffman and Cohen, 1999;Herek et al., 2005;Brown et al., 2007). As a result, some participants reported avoiding particular activities associated with fluid transfer, such as kissing and cunnilingus, in order to avoid disease transmission (Hoffman and Cohen, 1999;Brown et al., 2007). ...
... The earlier teaching interventions created opportunities for students to have contact with PLWHA in a meaningful way. The first study that incorporated organic contact with PLWHA into teaching came from the first decade of the epidemic and the field of community mental health (18). Following an introduction on the relationship between community mental health and living with HIV/AIDS, and clinical and epidemiological information on HIV/AIDS, Knox et al. introduced experiential components involving PLWHA in clinical tutorials in three modalities. ...
... [33][34][35] Such attitudes have been documented among a variety of health care personnel, including practicing physicians, medical students, nurses, and psychologists. [36][37][38] Although such negative attitudes are shown to diminish as health care personnel gain experience working with HIV-positive patients, they may still persist even among those who have worked with such clientele for many years. 39,40 Such attitudes have been linked to reluctance in health care personnel to interact with those living with the disease, in some cases leading to their refusal to provide care for HIV-positive patients. ...
... The authors of this research point out that this type of structural discrimination contributes to the internalization of mental illness stigma [3]. Furthermore, there is a body of research that describes service provider beliefs and attitudes that fuel the lack of competent practice related to topics of sex and intimacy [6,[41][42][43][44][45][46][47][48][49]. Many providers continue to hold outdated views of clients as asexual, exclusively heterosexual, or believe, paternalistically, that clients with psychiatric disabilities will decompensate and require hospitalization if they date or become sexually active. ...
... An average of more than 60% of the people with SMI correctly answered the questionnaire evaluating knowledge about HIV/AIDS (Guimarães, McKinnon, Campos, Melo & Wainberg, 2010; Knox, Boaz, Friedrich & Dow, 1994; Magagula, Mamabolo, Krüger & Fletcher, 2012; Otto-Salaj, Heckman, Stevenson & Kelly, 1998; Randolph et al., 2007; Stevenson & Eilers, 1992; Strauss, Bosworth, Stechuchak, Meador & Butterfield, 2006; Wainberg et al., 2008). Most of the research agrees that the level of knowledge of different groups of people with SMI is lower than that of the general population. ...
... Third, they joined community network meetings of HIV health care providers and agencies prioritizing mutual support. A subsequent quantitative evaluation of this clinical tutorial demonstrated increases in knowledge, and decreases in fear, discomfort and avoidance related to HIV (19). ...
... In Botswana, stigma has been shown to manifest at family, health facility and community level, perpetrated by health workers, among others. 17 A participant in this study described a stigmatising experience with a doctor. This has serious implications on the health-seeking behaviour and adherence to treatment by PLWHA. ...