Evaluating the Impact of the Positive Choices Intervention on Substance Use, Psychological, and Care Engagement Outcomes Relevant to Current National HIV Prevention Goals

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.

The Images of Democracy: Tocqueville and American Exceptionalism

This thesis addresses how Alexis de Tocqueville’s political thought is related to American Exceptionalism. First, I illustrate the multiple meanings of the concept of American Exceptionalism and in what sense it is indebted to Tocqueville. Second, I articulate how the historical background and personal qualities of Tocqueville contribute to the success of his masterpiece Democracy in America. In the main part, by analyzing Tocqueville’s Democracy in America and other writings on America, I argue that he indeed reveals America as exceptional and increasingly recognizes this idea through a process of intellectual development. An elaboration on Tocqueville’s theoretical contribution to the discussion of American Exceptionalism can reveal the different images of modern democracy as he suggests and how they would influence the prospect of human freedom.

They’re There, Now What?: The Identities, Behaviors, and Perceptions of Black Judges

Prior to the Civil Rights Movement, fewer than 50 Black judges had been elected or appointed to the judiciary. As of August 2015, there are over 1,000 Black state and federal judges. As the number of black judges has increased, one question arises: have American courts been altered purely by this substantial increase? One expectation—and, at times, a prediction—behind the increased descriptive representation of Black judges is that their mere presence would alter the judiciary. It was supposed that these judges would substantively represent Black interests in the decisions they made. In other words, it was suspected, and predicted, that Blacks in the judiciary would enhance equality and justice by being aware of, responsive to, and advocating for African Americans. This theory about the likely role of Black judges derives from theoretical work on political representation and racial group consciousness, and empirical studies of Black elite behavior in other political institutions.

Despite such predictions, there is no corresponding scholarly consensus regarding whether Black judges possess a racial group consciousness and have racially distinctive judicial behavior. Therefore, the theory undergirding the demand for increased diversification, as a means to transform the judiciary, remains unsubstantiated. This is precisely where this project, “They’re There, Now What?: The Identities, Behavior, and Perceptions of Black Judges,” seeks to intervene in and explore, if not settle, the matter of whether black judges possess a racial group consciousness and exhibit racially-distinctive judicial behavior. It addresses a set of interrelated questions relevant to understanding whether we can view Black judges as representatives in ways that are similar to how we view other Black political officials. I examine these questions using a multi-method approach. For my analyses, I draw on diverse materials: the published biographies of every Black judge appointed to the federal bench, a survey experiment with a nationally-representative adult sample, and semi-structured interviews with 30 Black judges.

This research, which engages with scholarship on representation, group consciousness, judicial behavior, and candidate perceptions, offers new insights into the lives, perceptions, and behavior of Black judges, as well as the manifestations of Black substantive representation in the judiciary. My dissertation argues that, despite the general reluctance to use the term “representation” when referring to judges, we can consider Black judges as representatives. Black judges behave as substantive representatives by (1) sharing and understanding the experience, history, and perspectives of Black Americans, (2) challenging language, persons, policies, and laws they feel negatively affect, or violate the rights and liberties of, African Americans, (3) respecting African American litigants, and (4) ensuring the rights of African Americans are protected and the needs of black Americans are being met.

Only through research that considers the perspectives, identities, perceptions, and behavior of Black judges will we arrive at a more comprehensive understanding of the importance of racial diversity in the courts. As this project finds, a link between descriptive representation and substantive representation can, and frequently does exist within the judicial context. Such a link is significant given that Blacks’ liberty and justice through the American legal system continues to be subject to those who exercise judicial power. This dissertation has implications for the discourse surrounding the need for increased descriptive and substantive representation of Blacks in the judiciary, and the factors that affect representation in the justice system.