1. Substance abuse and HIV/AIDS are serious problems in the United States, and while each has its own unique challenges, they also present similar issues. Each of the following is an example of this EXCEPT:
A. Both disorders are considered to be chronic and lifelong diseases
B. Studies have noted an increase in risk-taking behaviors among injection drug users who test positive for HIV
C. A diagnosis of HIV infection or related conditions can be a stressor for an individual already in recovery from a substance abuse disorder
D. Injection drug users who test positive for HIV are more likely to enter treatment than those who test negative
2. Transference is a term used to describe a set of thoughts, feelings, and beliefs experienced by a service provider that occurs in response to the client, and although sometimes these beliefs and feelings are conscious, generally they are not.
A. True
B. False
3. In working with clients with substance abuse issues and/or AIDS/HIV, counselors will likely encounter homosexual clients who have dealt with homophobia during their lifetimes. Acceptance and integration by lesbians and gays of the negative attitudes expressed by society toward them is known as:
A. Societal homophobia
B. Political homophobia
C. Oppressive homophobia
D. Internalized homophobia
4. Fear of HIV infection is one of the most challenging issues for counselors and is essential that providers examine this issue without blaming or judging themselves and others, and deal with this fear by discussing it and venting the feelings with someone who is safe, trusted, and informed
A. True
B. False
5. Lipodystrophy, a syndrome that occurs in early end-stage AIDS and produces altered body composition and various hormonal and physiological changes, is particularly distressing for women.
A. True
B. False
6. All of the following are accurate statements about cultural competency in counseling EXCEPT:
A. In many cultures people avoid discussing sex because they find such discussions disrespectful, so counselors should use a direct approach when initiating discussion about issues related to sex and sexual orientation to help alleviate these taboos
B. The socioeconomic status of the client and the client's degree of acculturation are essential factors when working with culturally, racially, or ethnically different populations
C. Counselors should value diversity and accept that the people they serve come from very different backgrounds and may make different choices based on culture
D. Counseling programs should be developed that incorporate alternative culturally enhancing experiences, develop problem solving skills, and teach about the origins of stereotypes and prejudice
7. Which of the following is a true statement about substance abuse issues as they relate to gay men, lesbians, bisexual men, and bisexual women?
A. In these populations, most studies have estimated an incidence of substance abuse of all types at approximately 20 percent, with ranges of 18 to 25 percent
B. A sudden increase in the use of methamphetamine, known as "speed," "crystal," "ice," or "crank," by lesbian and bisexual women has become a matter of grave concern
C. Young gay males in particular may be subjected to harassment at home or school, and they are prone to alcohol use, dropping out of school, running away, and getting involved in sex for drugs or money
D. Compared with lesbians, gay men are more likely to have lower incomes
8. The needs of women have always represented a unique challenge to health care and substance abuse treatment systems and a woman's identity as caregiver/caretaker must be recognized as an extremely powerful factor in how she accesses care and treatment and how successful she is in her recovery and health maintenance.
A. True
B. False
9. Asian women seek detoxification and treatment for substance abuse disorders in lower numbers than women from any other ethnic/cultural group.
A. True
B. False
10. All of the following are accurate statements about Hispanic populations and HIV/AIDS and substance abuse EXCEPT:
A. There is a clear increase in substance abuse as Hispanics become more acculturated
B. Providers should be aware of specific cultural issues that can support interventions and improve a provider's ability to engage Hispanic clients, such as the role of the family, the values of interdependence, and respect
C. Hispanics are underrepresented among HIV/AIDS cases for men, women, and children
D. Some Hispanic women who are HIV positive grieve deeply about the decision not to have children and may feel unfulfilled and inadequate as a result
11. HIV/AIDS disproportionately affects African Americans, and from July 1998 through June 1999, injection drug use accounted for 16 percent of AIDS cases among African American males and 16 percent of cases among African American females.
A. True
B. False
12. The fastest-growing segment of the U.S. HIV/AIDS pandemic is:
A. Minority men
B. Minority women
C. Minority teenagers
D. None of the above
13. CDC studies indicated that of the total AIDS cases reported for Asian Americans, 89 percent were in men and 79 percent of those were reported in men who have sex with men. Among women, nearly half the cases (48 percent) were associated with sex with an infected or high-risk partner, and 17 percent are reported from intravenous drug use.
A. True
B. False
14. Which of the following is an accurate statement about issues that pertain to Native Americans?
A. The CDC found that Native Americans have high rates of substance abuse, and they also lack access to diagnosis and treatment
B. The largest percentage of HIV and AIDS cases in Native American women was from IV drug use
C. HIV/AIDS is presently underreported for Native Americans and is based on the high incidence of STD’s in general, and thus substance abuse treatment centers will be faced with more and more HIV infected Native Americans
D. Both A and C above
15. The racial and class patterns characterizing arrest, adjudication, and sentencing in the United States skew more white Americans (regardless of social class or income) to treatment trajectories and more persons of color to jail or prison trajectories.
A. True
B. False
16. Adolescents are another group that is experiencing an increase in incidence and prevalence of HIV. All of the following are accurate statements about HIV and adolescents EXCEPT:
A. From the States for which HIV is a reportable condition, young people ages 13 to 24 accounted for a much greater proportion of HIV than AIDS cases
B. Of the reported HIV infections, 28 percent were reported among young females, and 46 percent were among African Americans
C. Adolescents may benefit from treatment that is developmentally appropriate and peer oriented
D. Studies note that teens are having sex earlier than ever before, often with multiple partners and inconsistent use of condoms, putting them at greater risk for HIV/AIDS
17. The last few years have witnessed greater increases in the number of HIV/AIDS cases among middle-aged and older individuals than in those under 40 years of age. Through June 1999, people over the age of 50 account for ___________ of cumulative AIDS cases and __________ of cumulative HIV cases in the United States.
A. 11 percent; 5 percent
B. 13 percent: 7 percent
C. 15 percent; 9 percent
D. 17 percent; 11 percent
18. What treatment programs should try to achieve in assisting the HIV-infected substance abuser is a base of clients who are as healthy as available treatment can make them, since a client who has stabilized his illness has a better chance of decreasing his substance use than one who has not.
A. True
B. False
19. Which of the following is an accurate statement about individual therapy for clients with HIV and substance abuse issues?
A. Individual therapy is optimal for consciousness raising and convincing clients to move toward a more consistent level of safe behaviors
B. Service providers should know that the initial phase of client change is usually the easiest for most clients, and it is after this that the difficult work begins
C. The idea of self-liberation can be used to influence a client to choose to act in a specific manner or believe in his ability to change
D. All of the above
20. Segregating groups by stage of HIV infection presents difficulties, but not doing so can also be problematic. All of the following are accurate statements about segregating clients in treatment EXCEPT:
A. Programs able to support separate groups may wish to use the two-group model, with groups consisting of clients newly aware of their positive HIV status and those with more advanced disease
B. Clients who are HIV positive but asymptomatic and attending a support group for the first time may be uncomfortable when encountering clients in the late stages of AIDS
C. Because treatment programs have limited resources, separating groups by stage of HIV infection may be impractical
D. In a group consisting solely of clients symptomatic with AIDS, members are vulnerable to becoming involved in a process of continual grieving so it may be helpful to establish support groups for time-limited periods
21. Counselors who will be working with clients at the end stages of AIDS should examine their own beliefs about death and dying, and in addition to this, counselors may need to learn about the physical and biological process of dying so that it can be explained to clients
A. True
B. False
22. Which of the following is NOT part of the five-stage bereavement and loss model, based on Elisabeth Kubler-Ross' book On Death and Dying?
A. Denial
B. Anger
C. Depression
D. Bereavement
23. It is estimated that the number of children orphaned by HIV/AIDS will increase by 100 percent in the next 20 years.
A. True
B. False
24. All of the following are accurate statements about HIV and relapse into substance abuse EXCEPT:
A. Physical and psychological stresses associated with HIV disease include pain, decreased functional ability, fatigue, and weakness, as well as fear, anxiety, grief, and possibly increased isolation and separation from loved ones, all of which increase individuals' risk of resuming substance abuse
B. HIV/AIDS milestones are significant for the client, her significant others, and her support network, and counselors often can anticipate crisis, upset, or a readiness for change when a client reaches an HIV/AIDS milestone
C. Clients should be dismissed from substance abuse treatment or HIV/AIDS support groups after a relapse, but may be allowed to return if they become rededicated to recovery
D. If a client relapses into a risk behavior for substance abuse, the counselor's role is to help the client to understand the conditions that caused the behavior to occur and to identify alternative behaviors that could have been substituted to prevent the relapse
25. In the case study with Frankie, the gay 21 year old homeless addict, the recommended treatment approach for working with him would be for him to commit to complete abstinence since he is at such high risk.
A. True
B. False
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