African-American adolescents' knowledge, health-related attitudes, sexual behavior, and contraceptive decisions: Implications for the prevention of adolescent HIV infection.

195 African-American adolescents completed measures of knowledge related to AIDS, attitudes toward condoms, health locus of control, vulnerability to HIV infection, peer sexual norms, personal sexual behavior for the past 6 mo, and contraceptive preferences. Hotelling's T–2 tests revealed that girls were more knowledgeable about AIDS, reported fewer sexual partners, held more positive attitudes toward precautionary sexual behavior, and perceived themselves to have greater control than boys. Five variables accounted for 44% of the variance in condom use: condom use from the 1st intercourse occasion, earlier grade in school, lower belief in an external locus of control, and higher scores on the Effect on Sexual Experience and Self-Control subscales of the Condom Attitude Scale. Implications for the content, format, and timing of HIV prevention with African-American adolescents are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of a social influence intervention on condom use and sexually transmitted infections among establishment-based female sex workers in the Philippines: A multilevel analysis.

The authors assessed the relative impact of structural and social influence interventions on reducing sexually transmitted infections (STIs) and HIV risk behavior among female sex workers in the Philippines (N = 897). Four conditions included manager influence, peer influence, combined manager-peer influence, and control. Intervention effects were assessed at the establishment level in multilevel models because of statistical dependencies among women employed within the same establishments. Control group membership predicted greater perceived risk, less condom use, less HIV/AIDS knowledge, and more negative condom attitudes. Combination participants reported more positive condom attitudes, more establishment policies favoring condom use, and fewer STIs. Manager-only participants reported fewer STIs, lower condom attitudes, less knowledge, and higher perceived risk than peer-only participants. Because interventions were implemented at the city level, baseline and follow-up city differences were analyzed to rule out intervention effects due to preexisting differences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Meal patterns prior to and following liver transplantation in rats

As the second part of a community based educational campaign to convey the risk of HIV/AIDS to commercial sex workers in Jakarta, from May-July 1995, a total of 253 male transvestites (WARIA) were questioned about their sexual behavior patterns and their knowledge and attitude toward HIV/AIDS. In the previous report, 1991-1993, there was one out of 830 WARIA found HIV positive in November 1993. In this study, 1995, a total of two out of 253 WARIA were confirmed of HIV infection in July 1995. Most of them still have incorrect knowledge on HIV/AIDS transmission mode, they are still practicing high risk sexual attitudes such as an exchange partner rate of 5 men per three weeks, low condom use (1.2 out of the last 5 sexual contacts). The reasons for not using condoms were forgetfulness 35.3% and partner does not like condom 38.2% Most of WARIA know about condoms (94.5%), but it is difficult to access condom use from small shops around them. Therefore, to prevent further spread of HIV/AIDS in WARIA, condom should be used constantly and properly. It has been shown from another study, that more information, better availability and better promotion of condoms can increase condom use. Thus, attention should be placed on various ways of distributing condoms for WARIA in Jakarta, especially community-based distribution by peer leaders, social marketing and commercial sales.     

HIV/AIDS risk in heterosexual college students. A review of a decade of literature

Empirical studies dealing with the psychosocial correlates of HIV risk among heterosexual college students are reviewed, including findings related to such theoretical variables as HIV/AIDS-related knowledge, personal and partner's attitudes toward condom use, perceived susceptibility, communication with sex partners, and sexual self-efficacy. Although college students are highly knowledgeable about basic HIV/AIDS facts, they retain some misperceptions about disease transmission. They hold neutral-to-negative hedonistic and practical attitudes about using condoms: those who have engaged in risky behavior accurately perceive their greater susceptibility to infection and experience anxiety regarding transmission of HIV infection. Heterosexual college students communicate infrequently with their partners about safer sex, but they often agree to a partner's suggestion that they use condoms. Higher levels of sexual self-efficacy among college students have been associated with a lower risk for HIV transmission. Limitations and clinical implications of the findings and recommendations for future interventions are discussed.     

The role of reactive nitrogen intermediates in modulation of gametocyte infectivity of rodent malaria parasites

Two hundred and fourteen young women received acquired immunodeficiency syndrome (AIDS) prevention interventions at an inner-city family health center serving minority patients predominantly. The community in which the health center is located has a high incidence of intravenous (IV) drug abuse. Either a peer or a health care provider delivered the intervention. In the peer-delivered intervention, a trained peer educator reviewed with patients an AIDS "Rap" videotape and several AIDS brochures, which imparted information about human immunodeficiency virus (HIV), its transmission, and prevention. In the provider-delivered intervention, family practice residents, attending physicians, and nurse practitioners used a patient-centered counseling approach to convey the same information. Questionnaires administered immediately before and after the intervention and at one month follow-up evaluated changes in knowledge, attitudes, and behavior. Analyses of data from both combined intervention groups revealed significant improvements in several areas of knowledge, including the effectiveness of using a condom and cleaning IV drug implements with bleach to prevent transmission of HIV. Many improvements were retained at the one-month follow-up. In addition, subjects in both groups who were sexually active stated immediately after the intervention that asking a sexual partner about past sexual experience would now be less difficult, and at one-month follow-up they reported a significant decrease in the frequency of vaginal sex. Our findings suggest that counseling by physicians can achieve more changes in knowledge of sexual risks, whereas peer education can achieve greater changes in knowledge about IV drug use. Results show that both approaches to AIDS prevention used in this study can significantly affect knowledge, attitudes, and sexual behavior.     

Reinforcement value of unsafe sex as a predictor of condom use and continued HIV/AIDS risk behavior among gay and bisexual men.

The pleasure or reinforcement value of high-risk sex may be an important influence on success in risk reduction efforts. Seronegative gay and bisexual men (N?=?297) completed measures assessing their unprotected and safer sex practices, as well as measures of cognitive and skill factors and a measure assessing the subjective reinforcement value of unprotected anal intercourse. Regression analyses showed that the reinforcement value of unprotected anal intercourse accounted for variance in predicting levels of condom use above that that could be accounted for by factors such as knowledge, behavior change intentions, perceived vulnerability, condom attitudes, and sexual communication skills. Only reinforcement value of unprotected sex and substance use significantly predicted how frequently participants engaged in high-risk sex. Increased attention to the valence of sexual reinforcers will improve HIV risk reduction models and enhance AIDS prevention efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Persuasive communications to change actions: An analysis of behavioral and cognitive impact in HIV prevention.

This meta-analysis examined the validity of various theoretical assumptions about cognitive and behavioral change following a communication recommending condom use. The synthesis comprised 82 treatment and 29 control groups included in 46 longitudinal reports with measures of perceived severity and susceptibility, attitudes and expectancies, norms, perceptions of control, intentions, knowledge, behavioral skills, or condom use. Results indicated that across the sample of studies, communications taught recipients about facts related to HIV and also induced favorable attitudes and expectancies, greater control perceptions, and stronger intentions to use condoms in the future. Moreover, messages that presented attitudinal information and modeled behavioral skills led to increased condom use. Results are discussed in the context of theories of human behavior and change and in reference to HIV-prevention interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Application of the social action theory to understand factors associated with risky sexual behavior among individuals in residential substance abuse treatment.

Risky sexual behavior (RSB) is a leading cause of HIV/AIDS, particularly among urban substance users. Using the social action theory, an integrative systems model of sociocognitive, motivational, and environmental influences, as a guiding framework, the current study examined (1) environmental influences, (2) psychopathology and affect, (3) HIV-related attitudes and knowledge, and (4) self-regulatory skills/deficits as factors associated with event-level condom use (CU) among a sample of 156 substance users residing at a residential substance abuse treatment center (M age = 41.85; SD = 8.59; 75% male). RSB was assessed using event-level measurement of CU given its advantages for improved accuracy of recall and ability for an examination of situational variables. A logistic regression predicting event-level CU indicated the significant contribution of partner type (environmental influences), less favorable attitudes towards condoms (HIV-related attitudes and knowledge), and higher levels of risk-taking propensity (self-regulatory skills/deficits) in predicting greater likelihood of not having used a condom at one's most recent sexual encounter. This study contributes to the literature examining HIV risk behaviors among substance users within a theory-driven model of risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Increasing condom use: Evaluation of a theory-based intervention to prevent sexually transmitted diseases in young women.

A multicomponent intervention to increase condom use in sexually active young women was designed, implemented, and evaluated in a randomized experiment. Participants were 198 unmarried female college students (mean age = 18.6 years) who received a 1-session condom promotion intervention or a control (stress management) intervention. The condom promotion intervention led to increased self-reported condom use up to 6 months following intervention as well as positive changes in perceived benefits of condom use, affective attitudes toward condom use and condom users, perceived acceptance of sexuality, control over the sexual encounter, perceived self-efficacy for condom use, and intentions to use condoms. Mediational analysis illustrated the mechanisms of the condom promotion intervention effects, linking psychological constructs affected by the intervention (perceived benefits, acceptance of sexuality, control over the sexual encounter, attitudes toward condoms, and self-efficacy for condom use) to condom use intentions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol outcome expectancies, attitudes toward drinking and the theory of planned behavior

OBJECTIVE: The present study investigated whether alcohol outcome expectancies are empirically distinguishable from attitudes toward drinking. Specifically, the contribution of expectancies and attitudes to the Theory of Planned Behavior was assessed. METHOD: Undergraduates (N = 316; 170 male), of legal drinking age, who drank at least once a month participated. Intentions to drink "too much" and self-report excessive consumption episodes served as criterion measures, and attitudes, subjective norm, perceived behavioral control and alcohol outcome expectancies were employed as predictor variables. Stepwise regression analyses were performed separately for men and women. RESULTS: The Theory of Planned Behavior appeared to be a valid framework for predicting excessive alcohol consumption among undergraduates. The predictive power of the model, however, was enhanced through the inclusion of gender-specific alcohol outcome expectancies. Specifically, in addition to attitudes and perceived behavioral control, women's expectancies for sociability enhanced the prediction of intentions to drink "too much." Expectancies for sexual functioning (male) and assertiveness (female) improved the prediction of excessive consumption, over and above intentions and perceived behavioral control. CONCLUSIONS: Alcohol outcome expectancies, unlike attitudes, are proximal predictors of excessive alcohol consumption among undergraduates.     

Campus courtship behavior and fear of human immunodeficiency virus infection by university students

Data were collected by telephone from a random sample of 762 students at the University of Northern Colorado to examine students' fear of human immunodeficiency virus (HIV) infection and their suggested approaches to prevent the spread of the disease. Of the 762 students interviewed, 177 (24.1%) believed that HIV/acquired immunodeficiency syndrome (AIDS) was a threat to socialization on campus. Fourteen percent of the female students considered HIV/AIDS to be a threat compared with 10.1% of their male counterparts. Among all interviewees, 573 (76.7%) believed HIV/AIDS was a threat to romance at the university. Statistically significant association was found between the perceived fear of HIV/AIDS and gender. With regard to actual sexual intercourse, 86.4% of the students believed that HIV/AIDS was a major threat compared with 13.6% who did not. The association between the perception about HIV/AIDS as a threat to on-campus sexual intercourse and gender was statistically significant. Of the entire sample, 69.3% suggested abstinence as an approach to avoid HIV infection. Slightly more than 24% suggested condom use. Eighteen (10.8%) students advised that sexual contact should be only with a trusted partner. More information about HIV/AIDS should be provided to all students, especially women, in institutions of higher learning. More information can reduce the fear associated with this deadly disease.     

Expectancies as mediators of the effects of social influences and alcohol knowledge on adolescent alcohol use: A prospective analysis.

Three-year panel data from 789 students in 8th grade and path-analytic techniques were used to test a model positing that social reinforcement expectancies mediate the effects of perceived friends' alcohol use, friends' alcohol attitudes, and knowledge of near-term health effects and alcohol prevalence on both contemporaneous and subsequent alcohol involvement. Evidence of mediation was obtained with both cross-sectional and longitudinal findings. Perceived peer norms had a direct effect on alcohol use, and knowledge of normative alcohol use had a unique long-term protective influence on later alcohol use. Findings are discussed in terms of a 2-pronged prevention model that (a) integrates principles of social learning theory with expectancy-based, cognitive-behavioral change and (b) emphasizes dissemination of age-appropriate alcohol information in programs that aim to reduce alcohol use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Healthy for Life project: sexual risk behavior outcomes

Sexual risk behavior outcome data from the Healthy for Life (HFL) project is presented. Using a social influences model, the intervention was designed to positively affect the health behaviors of middle school students in five related areas: alcohol use, tobacco use, marijuana use, nutrition, and sexuality. The in-school program was supplemented by parent, community and peer components. The research used self-report data on an initial sample of 2,483 middle school students followed from Grade 6 to Grade 10. Twenty-one schools were assigned to three conditions--age appropriate (program taught in Grades 6, 7, and 8), intensive (program taught in Grade 7) and control--using blocked randomization. Attrition was 20% (by Year 4) and 33% (by Year 5). By ninth grade the lifetime intercourse rate among both groups of HFL subjects was significantly higher than for controls (controlling for baseline substance use risk and involvement with the opposite sex), but reported past month intercourse rates and condom use did not differ. At the tenth grade follow-up, the age appropriate subjects reported higher adjusted rates of lifetime and past month intercourse than did the controls. Intensive subjects perceived significantly lower normative rates of intercourse than controls at ninth grade follow-up, but age appropriate subjects perceived significantly higher norms at tenth grade. Our expectation that this approach would be effective in reducing adolescent sexual risk behavior has not been supported. The influence of social and community norms and contextual factors has a far greater influence on the behavior of students (even 6 years later) than this school-based social influences program targeting only one grade cohort.     

Social cognitive processes mediating the relationship between exposure to television's sexual content and adolescents' sexual behavior.

This study used multiple-group structural equation modeling to test a model explaining the association between exposure to televised sexual content and initiation of intercourse among an ethnically diverse national sample of 1,292 adolescents. The authors hypothesized, on the basis of social-cognitive theory, that exposure to televised sexual content would influence adolescents' safe-sex self-efficacy, sex-related outcome expectancies, and perceived peer norms regarding sex, and that each of these would, in turn, influence intercourse initiation. Findings support a model in which the relationship between exposure to TV's sexual content and intercourse initiation is mediated by safe-sex self-efficacy among African Americans and Whites but not among Hispanics. Outcome expectancies and perceived peer norms may also mediate the link between exposure and intercourse initiation among all 3 racial/ethnic groups, although evidence of this could not be confirmed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of a drinking event on behavioral skills and condom attitudes in men: Implications for HIV risk from a controlled experiment.

This study experimentally tested the effects of a drinking event on HIV-related behavioral skills and condom attitudes. Sixty unmarried, heterosexual men were assigned to 1 of 3 conditions (sober, placebo, or alcohol). Participants who consumed alcohol demonstrated lower skill to negotiate for condom use relative to sober controls. More negative condom attitudes were expressed by participants with stronger sex-related alcohol expectancies, especially when these expectancies were triggered by subjective intoxication. Hierarchical regression analyses revealed that the experimental factors accounted for variance in behavioral skills and condom attitudes beyond that explained by known predictors of sexual risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol's effects on requisites for sexual risk reduction in men: An initial experimental investigation.

The effects of alcohol intoxication on mediators of condom use were examined in a laboratory-based experiment. Twenty men were randomly assigned to either an alcohol or a nonalcohol beverage administration condition. Participants in the experimental condition drank vodka and tonic to achieve a blood alcohol level of 0.08%, whereas controls drank tonic only. All participants then completed a battery of measures related to condom and AIDS-related knowledge, motivation to use condoms, and behavioral self-efficacy regarding condom use. Findings from this exploration study, which should be considered preliminary because of the small sample size, indicated that participants who received alcohol tended to report more negative attitudes toward condoms and lower self-efficacy to initiate condom use than controls. AIDS knowledge, appraisal of social norms regarding condom use, and perceived risk of infection were unaffected by alcohol consumption. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Young women's condom use: The influence of acceptance of sexuality, control over the sexual encounter, and perceived susceptibility to common STDs.

A comprehensive model of the determinants of condom use among young women was developed, tested, and replicated, with longitudinal follow-up to assess predictive utility of the model for condom use over time. Participants in Study 1 and Study 2 were 198 female undergraduates (mean age, 18.6 years) and 238 female undergraduates (mean age, 19.1 years), respectively. Acceptance of sexuality and control over the sexual encounter were related to a multidimensional measure of condom use self-efficacy, which predicted condom use intentions. Perceived susceptibility to STDs was both directly related to intentions and indirectly related through perceived benefits and attitudes about condom use. Intentions predicted subsequent reports of condom use. The model suggests foci for condom use interventions for young women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trends in attitudes and behaviour relevant to AIDS in Ugandan community

Behaviour-related preventive measures are still the main weapon against the spread of AIDS. Intensive AIDS prevention and control activities conducted over the last ten years need to be evaluated on the basis of their impact on attitudes and behaviour relevant to AIDS. The main objective of this study was to document and evaluate trends in attitudes and behaviour relevant to AIDS in a Ugandan community over a seven year follow up period. The study was a longitudinal community-based closed cohort. Periodic surveys were conducted on the study group and data on condom use, attitudes about condoms, rates of sexual partner change and reported frequency of sexually transmitted diseases were collected in all surveys. Data reported are from surveys conducted during 1987, 1992 and 1994 in which similar questions were asked and emerging trends identified. Reported condom use ever, increased from 3.9% in 1987 to 10.1% in 1992 and to 27.2% in 1994. This is a 7.3 fold increase over seven years. In females, reported use of condoms increased from 1.2% in 1987 to 18.2% in 1994 while in males it increased from 6.9% to 35.3% over the same period. In this study group there are still more people opposed to the ongoing intensive condom campaign than there are those supporting it. The percentage supporting the campaign was 28% in 1987, 26% in 1992 and 40.8% in 1994. This is a rising trend. The rate of sexual partner change has declined. During the baseline survey, 26.5% of the respondents reported that they had intercourse with two or more sexual partners in the six months period before the interview. This proportion decreased to 6.8% in 1992 but then increased to 17.1% in 1994. During the baseline survey, 2.6% of the study group reported that they had sexual intercourse with six or more partners during the six months period before the interview but during the 1992 and 1994 surveys, no one reported sexual intercourse with more than five partners during a similar period. The reported frequency of sexually transmitted diseases during a twelve month recall period, reflecting STD incidence, decreased from 3.5% in 1992 to 1.9% in 1994. In conclusion during the seven year followup period of this community-based closed cohort, we have identified a sharp increase in condom use, a reduced rate of sexual partner change and a decline in the reported frequency of sexually transmitted disease. The percentage of people supporting the condom campaign is rising. These are some of the outstanding outcomes of the AIDS prevention activities conducted in the country over the last 10 years.     

Differences between completers and early dropouts from 2 HIV intervention trials: a health belief approach to understanding prevention program attrition

OBJECTIVES: The purpose of this study was to identify factors predicting program attrition among participants in human immunodeficiency virus (HIV) risk reduction trials. METHODS: Participants were gay/bisexual men and severely mentally ill adults recruited to take part in HIV risk reduction small-group interventions. Program completers were compared with participants who were assessed at baseline but then failed to attend any sessions. The health belief model provided a framework for selection of possible predictors of program attrition. RESULTS: Younger age was associated with early dropout in both samples. Other predictors among gay/bisexual men included involvement in an exclusive sexual relationship, minority ethnicity, injection drug use, and higher perceived severity of AIDS. Severely mentally ill dropouts were less knowledgeable about safer sex methods and more likely to hold positive outcome expectancies for condom use. CONCLUSIONS: Evaluation of intervention effectiveness among vulnerable population segments is threatened if there is selective attrition. Better methods are needed to attract and maintain participation in HIV prevention programs. Alternatively, wider application of "intention to treat" analysis of intervention outcomes is recommended to minimize selection bias due to program dropout.