Close relationships and elevated HIV risk behavior: Evidence and possible underlying psychological processes.

A review of research on AIDS preventive behavior indicates that minority and nonminority heterosexual adolescents and adults, gay men, injection drug users, and commercial sex workers are all less likely to practice safer sex with close relationship partners, compared with partners they perceive to be "casual" sexual partners. Because many individuals in close relationships have engaged in HIV risk behavior over extended periods of time and are unaware of their actual HIV status, practicing unprotected sexual intercourse with a committed relationship partner who is not tested for HIV appears to be a major and unrecognized source of HIV risk. This article reviews the evidence for higher levels of HIV risk behavior in close relationships and then presents relevant conceptual and empirical work to explore the psychological processes that may underlie risky sexual behavior in close relationships, using as a framework the information-motivation-behavioral skills model of preventive behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Smoked cocaine self-administration in females and voucher incentives for abstinence

Although some individuals are able to cope well with the challenges posed by HIV and AIDS, others experience psychological difficulties. This article reviews factors that facilitate or hinder successful coping with HIV including preexisting psychological functioning, medical health status, quality and adequacy of social support, stress-and-coping style, and perceived expected benefits of treatment. The article reviews studies evaluating the effects of group psychotherapy intervention for persons living with HIV. The article then describes clinical issues encountered in therapy groups for persons with HIV. These clinical issues include the presence of coexisting problems unrelated to HIV/AIDS, disclosure of HIV-positive serostatus to others, making changes in transmission-risk-behavior practices, AIDS-related bereavement and caregiving stress, establishing social supports, adhering to medical care regimens, and developing a positive self-identity as a person living with HIV. Practical considerations of group therapy for HIV-positive clients are also described.     

Opt-out testing for stigmatized diseases: A social psychological approach to understanding the potential effect of recommendations for routine HIV testing.

Objective: Little research has studied experimentally whether an opt-out policy will increase testing rates or whether this strategy is especially effective in the case of stigmatized diseases such as HIV. Design and Main Outcome Measures: In Study 1, a 2 × 2 factorial design asked participants to make moral judgments about a person’s decision to test for stigmatized diseases under an opt-in versus an opt-out policy. In Study 2, a 2 × 2 factorial design measuring testing rates explored whether opt-out methods reduce stigma and increase testing for stigmatized diseases. Results: Study 1 results suggest that getting tested draws suspicion regarding moral conduct in an opt-in system, whereas not getting tested draws suspicion in an opt-out system. Study 2 results suggest that an opt-out policy may increase testing rates for stigmatized diseases and lessen the effects of stigma in people’s reluctance to test. Discussion: A social psychological approach to health services can be used to show how testing policies can influence both the stigmatization associated with testing and participation rates. An understanding of how testing policies may affect patient decision making and behavior is imperative for creating effective testing policies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in HIV treatment beliefs and sexual risk behaviors among gay and bisexual men, 1997-2005.

Objective: Beliefs about HIV treatment effectiveness and the impact of HIV treatments on HIV transmission risks were initially related to sexual risk-taking in the late 1990s when multidrug HIV treatments first became available. This study examined changes in beliefs about the effects of HIV treatment for preventing HIV transmission and their association to sexual risk behaviors between the years 1997 and 2005. Design: Anonymous surveys were administered to a convenience sample of gay and bisexual men attending a large community event in Atlanta, Georgia in 1997 (N = 498) and again at the same community event in 2005 (N = 448). Analyses were performed for men living with HIV/AIDS and for men who have not been diagnosed with HIV/AIDS. Main Outcome Measures: Rates of unprotected anal intercourse in the previous 3 months. Results: There were significant increases in high-risk sexual practices that coincided with increased beliefs that HIV treatments can reduce the chance of transmitting HIV. However, optimistic beliefs about the health benefits of HIV treatments decreased over the 8 years and were not related to risk behaviors. Conclusions: Beliefs about how HIV treatments impact HIV infectiousness remain associated with HIV transmission risk behavior and interventions targeting at-risk as well as HIV-positive men who have sex with men must directly address these beliefs and perceptions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A study on disclosure by HIV positives by use of simulation using case vignettes

AIDS patients/HIV positives have been increasing in Japan, but a large proportion of university students, who have high risk sexual behavior, are not aware of the danger of HIV infection. Because of little disclosure by AIDS patients/HIV positives in Japan, the students have a poor chance of knowing of their risk in sexual behavior situations. Discrimination or prejudice toward AIDS patients/HIV positives has suppressed disclosure. However, as the real risk changes of disclosure is unknown, a simulation study, using case vignettes, was carried out to measure risks. A total of 1,128 university students (487 male and 641 female) were asked to read one of six vignettes describing HIV positives, that consisted of three infection routes (one by blood preparation and two by sexual intercourse) with disclosure or without disclosure. After reading a vignette, they answered questions about the images of HIV positives and their attitudes to him or her. As a result of reading these vignettes, friendly images were enhanced and the disagreeable images were decreased, but students' attitudes were unchanged. Significant differences were recognized in attitudes concerning responsibility for the infection and sympathy toward HIV positives, depending on the infection routes (blood preparation or sexual intercourse). Female students had a tendency to be more favorable to HIV positives than the male students. This simulation study showed the difficulty of changing students' attitudes regardless of the image of HIV positives, and demonstrated the need for effective action toward reducing discrimination or prejudice.     

Relationship of HIV testing and high-risk behaviors among clients in methadone maintenance treatment

This article reports on the association between frequency of HIV testing and high-risk behaviors among 339 individuals in the Los Angeles Enhanced Methadone Maintenance Project. Individuals who reported taking three or more HIV tests prior to entering treatment (45% of the sample) were more likely to know someone who was HIV positive, to engage in illegal activity, to perceive their risk for HIV as high, and to use condoms; they were less likely to disinfect injection equipment; and they scored higher on measures of HIV knowledge and depression as compared with less frequent testers. The strongest predictor of frequent HIV testing (three or more tests) after treatment entry, reported by 43% of the sample, was having a high number of injection-sharing partners. Although a substantial number of individuals in methadone maintenance treatment continued to take HIV tests, test taking was more strongly related to high-risk injection behavior than to sexual behavior.     

The effects of moral judgment and moral identity on moral behavior: An empirical examination of the moral individual.

Recognizing limitations in classic cognitive moral development theory, several scholars have drawn from theories of identity to suggest that moral behavior results from both moral judgments and moral identity. The authors conducted 2 survey-based studies with more than 500 students and managers to test this argument. Results demonstrated that moral identity and moral judgments both independently influenced moral behavior. In addition, in situations in which social consensus regarding the moral behavior was not high, moral judgments and moral identity interacted to shape moral behavior. This interaction effect indicated that those who viewed themselves as moral individuals pursued the most extreme alternatives (e.g., never cheating, regularly cheating)--a finding that affirms the motivational power of a moral identity. The authors conclude by considering the implications of this research for both theory and practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reconciling the self and morality: An empirical model of moral centrality development.

Self-interest and moral sensibilities generally compete with one another, but for moral exemplars, this tension appears to not be in play. This study advances the reconciliation model, which explains this anomaly within a developmental framework by positing that the relationship between the self’s interests and moral concerns ideally transforms from one of mutual competition to one of synergy. The degree to which morality is central to an individual’s identity—or moral centrality—was operationalized in terms of values advanced implicitly in self-understanding narratives; a measure was developed and then validated. Participants were 97 university students who responded to a self-understanding interview and to several measures of morally relevant behaviors. Results indicated that communal values (centered on concerns for others) positively predicted and agentic (self-interested) values negatively predicted moral behavior. At the same time, the tendency to coordinate both agentic and communal values within narrative thought segments positively predicted moral behavior, indicating that the 2 motives can be adaptively reconciled. Moral centrality holds considerable promise in explaining moral motivation and its development. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Embodiment, agency, and attitude change.

Attitude embodiment effects occur when the position or movement of a person’s physical body changes the way the person evaluates an object. The present research investigated whether attitude embodiment effects depend more on biomechanical factors or on inferential cues to causal agency. Experiments 1 and 2 showed that actual movements of the physical body are not necessary to create attitude embodiment effects when inferential cues imply agency for another person’s physical movements. Experiment 3 showed that actual movements of the physical body are not sufficient to create attitude embodiment effects when inferential cues imply nonagency for those movements. In all 3 experiments, inferential cues to agency played a more important role in attitude embodiment effects than did actual agency, suggesting that theories of embodiment and attitude embodiment need to consider inferential cues to agency alongside biomechanical mechanisms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-efficacy and disclosure of HIV-positive serostatus to sex partners.

HIV-positive persons face significant challenges to disclosing their HIV serostatus, and failure to disclose can place their sex partners at risk. The current study examined HIV serostatus disclosure in 266 sexually active HIV-positive persons recruited from the community. Results showed that 41% had not disclosed their HIV serostatus to sex partners. Men who had not disclosed to partners indicated lower rates of condom use during anal intercourse and scored significantly lower on a measure of self-efficacy for condom use compared to individuals who had disclosed. Emotional distress was also greatest among persons who had not recently disclosed. Having not disclosed to sex partners was closely associated with lower self-efficacy for disclosing, with women who had not disclosed reporting the lowest disclosure self-efficacy. As people living with HIV-AIDS are encouraged to disclose their HIV status, interventions are needed to facilitate disclosure decision making. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Moral attentiveness: Who pays attention to the moral aspects of life?

This research draws from social cognitive theory to develop a construct known as moral attentiveness, the extent to which an individual chronically perceives and considers morality and moral elements in his or her experiences, and proposes that moral attentiveness affects a variety of behaviors. A series of 5 studies with undergraduates, MBA students, and managers were conducted to create and validate a reliable multidimensional scale and to provide evidence that moral attentiveness is associated with (a) the recall and reporting of self- and others' morality-related behaviors, (b) moral awareness, and (c) moral behavior. Results of the studies suggest that moral attentiveness has a significant effect on how individuals understand and act in their moral worlds. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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 integration of agency and communion in moral personality: Evidence of enlightened self-interest.

Agency and communion are fundamental human motives, often conceptualized as being in tension. This study examines the notion that moral exemplars overcome this tension and adaptively integrate these 2 motives within their personality. Participants were 25 moral exemplars—recipients of a national award for extraordinary volunteerism—and 25 demographically matched comparison participants. Each participant responded to a life review interview and provided a list of personal strivings, which were coded for themes of agency and communion; interviews were also coded for the relationship between agency and communion. Results consistently indicated that exemplars not only had both more agency and communion than did comparison participants but were also more likely to integrate these themes within their personality. Consistent with our claim that enlightened self-interest is driving this phenomenon, this effect was evident only when agency and communion were conceptualized in terms of promoting interests (of the self and others, respectively) and not in terms of psychological distance (from others) and only when the interaction was observed with a person approach and not with the traditional variable approach. After providing a conceptual replication of these results using different measures elicited in different contexts and relying on different coding procedures, we addressed and dismissed various alternative explanations, including chance co-occurrence and generalized complexity. These results provide the first reliable evidence of the integration of motives of agency and communion in moral personality. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Moral disengagement in ethical decision making: A study of antecedents and outcomes.

This article advances understanding of the antecedents and outcomes of moral disengagement by testing hypotheses with 3 waves of survey data from 307 business and education undergraduate students. The authors theorize that 6 individual differences will either increase or decrease moral disengagement, defined as a set of cognitive mechanisms that deactivate moral self-regulatory processes and thereby help to explain why individuals often make unethical decisions without apparent guilt or self-censure (Bandura, 1986). Results support 4 individual difference hypotheses, specifically, that empathy and moral identity are negatively related to moral disengagement, while trait cynicism and chance locus of control orientation are positively related to moral disengagement. Two additional locus of control orientations are not significantly related to moral disengagement. The authors also hypothesize and find that moral disengagement is positively related to unethical decision making. Finally, the authors hypothesize that moral disengagement plays a mediating role between the individual differences they studied and unethical decisions. Their results offer partial support for these mediating hypotheses. The authors discuss the implications of these findings for future research and for practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol use, expectancies, and sexual sensation seeking as correlates of HIV risk behavior in heterosexual young adults.

Most theoretical models of HIV risk behavior have not considered the role of personality factors, and few studies have examined mechanisms accounting for dispositional influences on sexual risk taking. This study elaborated on a conceptual model emphasizing sexual sensation seeking, alcohol expectancies, and drinking before sex as key predictors of HIV risk (S. C. Kalichman, L. Tannenbaum, & D. Nachimson, 1998). Multiple groups structural equation modeling was used to determine whether gender moderated relationships among these variables in a sample of 611 heterosexual, young adult drinkers (49% women, 76% Caucasian, mean age = 25 years). The model provided an excellent fit to the data, and gender differences were not substantiated. Sexual sensation seeking predicted HIV risk directly as well as indirectly via sex-related alcohol expectancies and drinking in sexual contexts. Findings suggest that expectancies and drinking before sex represent proximal mechanisms through which dispositional factors influence sexual risk outcomes. Moreover, these relationships appear to be similar in men and women. Interventions could benefit from targeting alcohol expectancies and drinking before sex in individuals with a dispositional tendency toward sexual risk taking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nature, decay, and spiraling of the effects of fear-inducing arguments and HIV counseling and testing: A meta-analysis of the short- and long-term outcomes of HIV-prevention interventions.

[Correction Notice: An erratum for this article was reported in Vol 26(6) of Health Psychology (see record 2007-16656-022). Several corrections that were omitted are found in this erratum.] Objective: To examine the long-term efficacy of both fear-inducing arguments and HIV counseling and testing at encouraging and maintaining knowledge about HIV transmission and prevention, as well as condom use. Design: Analyses were conducted with a sample of 150 treatment groups and 34 controls and included measures of change at an immediate follow-up and a delayed follow-up. Main outcome measures: The main outcome measures were perceived risk of HIV infection, knowledge about HIV, and condom use. Results: Results indicated that receiving fear-inducing arguments increased perceptions of risk at the immediate follow-up but decreased knowledge and condom use, whereas resolving fear via HIV counseling and testing decreased perceptions of risk and increased knowledge and condom use at both the immediate and delayed follow-ups. The effects on perceived risk and knowledge decreased over time, but the effects on condom use became more pronounced. Conclusion: Inducing fear is not an effective way to promote HIV-relevant learning or condom use either immediately following the intervention or later on. However, HIV counseling and testing can provide an outlet for HIV-related anxiety and, subsequently, gains in both knowledge and behavior change immediately and longitudinally. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Women, sex, and HIV: Social and contextual factors, meta-analysis of published interventions, and implications for practice and research.

This article is focused on examining social and contextual factors related to HIV-risk behavior for women. Specifically, this article has three main purposes: to review the literature on selected social and contextual factors that contribute to the risk for the heterosexual transmission of HIV and AIDS, to review and conduct a meta-analysis of HIV-prevention interventions targeting adult heterosexual populations, and to suggest future directions for HIV-prevention intervention research and practice. Results suggest that the HIV-prevention interventions reviewed for this article had little impact on sexual risk behavior, that social and contextual factors are often minimally addressed, and that there was a large gap between research and the practice of HIV-prevention intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological Bulletin: Correction to Logan et al. (2002).

Reports errors in the original article by T. K. Logan et al (Psychological Bulletin, 2002, Vol 128[6], 851-885). Errors in Table 1 (p. 862), Table 2 (p. 863), and Table 4 (p. 865) are noted and corrected. Errors in the text on page 869 and page 871 also are corrected. (The following abstract of this article originally appeared in record record 2002-18663-001). This article is focused on examining social and contextual factors related to HIV-risk behavior for women. Specifically, this article has three main purposes: to review the literature on selected social and contextual factors that contribute to the risk for the heterosexual transmission of HIV and AIDS, to review and conduct a meta-analysis of HIV-prevention interventions targeting adult heterosexual populations, and to suggest future directions for HIV-prevention intervention research and practice. Results suggest that the HIV-prevention interventions reviewed for this article had little impact on sexual risk behavior, that social and contextual factors are often minimally addressed, and that there was a large gap between research and practice of HIV-prevention intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The intelligence of the moral intuitions: A comment on Haidt (2001).

The social intuitionist model (J. Haidt, see record 2001-18918-008) posits that fast and automatic intuitions are the prim source of moral judgments. Conscious deliberations play little causal role; they are used mostly to construct post hoc justifications for judgments that have already occurred. In this article, the authors present evidence that fast and automatic moral intuitions are actually shaped and informed by prior reasoning. More generally, there is considerable evidence from outside the laboratory that people actively engage in reasoning when faced with real-world moral dilemmas. Together, these facts limit the strong claims of the social intuitionist model concerning the irrelevance of conscious deliberation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The rejection of moral rebels: Resenting those who do the right thing.

Four studies document the rejection of moral rebels. In Study 1, participants who made a counterattitudinal speech disliked a person who refused on principle to do so, but uninvolved observers preferred this rebel to an obedient other. In Study 2, participants taking part in a racist task disliked a rebel who refused to go along, but mere observers did not. This rejection was mediated by the perception that rebels would reject obedient participants (Study 3), but did not occur when participants described an important trait or value beforehand (Study 4). Together, these studies suggest that rebels are resented when their implicit reproach threatens the positive self-image of individuals who did not rebel. (PsycINFO Database Record (c) 2010 APA, all rights reserved)