The role of risk perception and efficacy cognitions in the prediction of HIV-related preventive behavior and condom use

The salience of the Protection Motivation Theory to HIV preventive behavior was investigated in a sample of 468 heterosexual men 20-45 years of age recruited in Germany and at vacation spots in Spain. This theory conceptualizes self-protective behaviors as a function of the severity of the threat, perceived personal vulnerability to this threat, the availability of coping responses, and the effectiveness of these responses. Cognitive variables measured included perceived severity of the threat of AIDS, sexual self-efficacy expectancy, self-efficacy expectations in terms of sexual communication skills, response efficacy, and attitude toward condom use. On a scale of 1 (low) to 6 (high), perceived severity of the AIDS threat averaged 5.3, individual susceptibility ratings averaged 3.5, and susceptibility of peers had a mean of 4.9. Although 33% of respondents had made behavioral changes in response to the AIDS epidemic, only 15% always used condoms while 12% used them occasionally. Self-efficacy expectancy with regard to assertiveness and use of preventive measures emerged as the most significant predictor of HIV-related behaviors. The causal analyses indicated that high communicative self-efficacy expectancy is associated with high-risk sexual behaviors, while self-efficacy expectancy regarding assertiveness and the use of preventive measures promotes risk reduction. These associations were strongest in men over 26 years of age, singles, and tourists. These findings suggest a need for interventions for couples such as assertiveness training and guidance on communicating about sex and AIDS. Also demonstrated was the need for AIDS education programs to identify where participants are in terms of perceiving the threat of and coping with the AIDS epidemic and promote conditions that will help people advance to the next stage.     

The 90's: gender differences in AIDS-related sexual concerns and behaviors,condom use and subjective condom experiences

To evaluate gender differences in the subjective experience and use of condoms, 193 heterosexual patrons at 13 bars in New York City were interviewed on site in 1991. Most respondents were single, middle class, and White; their ages ranged from 18 to 51 years. The data analysis was restricted to the 155 men and women who had at least 1 new partner in the 3 years preceding the survey. Respondents worried most about acquired immunodeficiency syndrome (AIDS) when engaging in sex with a new partner. 86% indicated concern about AIDS had affected their sexual behavior, most often by increasing their condom use and decreasing casual sex. 91% of women and 79% of men said that condoms give them greater peace of mind. Women worried more than men about AIDS when they had a new sexual partner and were more likely to limit their number of partners, work harder on an existing sexual relationship, give up casual sex, or give up sex with new partners. Men's subjective condom experiences were related to their penile functioning (erection and ejaculation) and the threat of loss of sexual pleasure. Multiple regression equations revealed that, among men, condom use with new partners was associated with worrying about AIDS and younger age; among women, peace of mind was a positive predictor. With casual partners, more partners led to increased condom use among women and worrying about AIDS was a predictor for men; peace of mind was predictive for both genders. 53% of men compared to 21% of women expected to meet a new sexual partner at the bar where they were interviewed, and 36% of men and 19% of women were carrying condoms with them.     

Optimism, coping, psychological distress, and high-risk sexual behavior among men at risk for acquired immunodeficiency syndrome (AIDS).

In a cohort of gay men responding to the threat of acquired immunodeficiency syndrome (AIDS), dispositional optimism was associated with less distress, less avoidant coping, positive attitudes as a coping strategy, and fewer AIDS-related concerns. Men who knew they were seropositive for human immunodeficiency virus (HIV) were significantly more optimistic about not developing AIDS than men who knew they were seronegative for HIV. This AIDS-specific optimism was related to higher perceived control over AIDS and to active coping among seropositive men only and to health behaviors in both serostatus groups. There was no relation of optimism to risk-related sexual behavior. It is concluded that optimism is psychologically adaptive without necessarily compromising health behavior. It is also concluded that it is useful to distinguish between event-based optimistic expectations and dispositional optimism.     

The Perceived Influence of AIDS Advertising: Third-Person Effects in the Context of Positive Media Content

Although there is consistent evidence indicating that people perceive themselves to be less influenced than others by negative media content and persuasive communications with negative intent (viz., a third-person effect), much less is known about the perceived impact of positive media content and public service advertisements. This study investigated the perceived impact of 11 AIDS advertisements promoting a common message for safe sex, in an attempt to clarify the conditions in which people might judge themselves as more, rather than less, influenced than others. Results indicated that student respondents perceived themselves as less vulnerable than others to low-quality AIDS advertisements, but as more influenced than others by high-quality AIDS advertisements. Respondents who believed strongly that it is good to be influenced by AIDS campaigns saw themselves as relatively vulnerable to such messages, whereas other respondents did not distinguish between the level of impact on self and other. Results are consistent with motivational accounts that emphasize the ego-enhancing function of social comparisons.     

The relationship between research and design of AIDS prevention program

The global threat of AIDS requires massive public educational campaigns that employ social and behavioral sciences such as psychology, sociology, and anthropology because sexual behavior possesses a social dimension. Research is concerned with what stimulates behavioral change, what are the prerequisites of learned behavior, and what enables personal control over the environment and future. Educational programs designing strategies for AIDS prevention require social and behavioral science content and input. Interdisciplinary provides general principles with psychological, social, and cultural aspects of human behavior. Without knowledge about psychological processes (thinking, perception, speech, aspects of personality, and interactive behavior) and social processes (economic conditions, social networks, and resources) which are implicated in health problems and also in AIDS, these educational programs cannot produce credible results. These programs and their subsequent implementation require their application in practice in a systemic and consistent fashion. Evaluations are also needed to make sure that the applied processes for behavioral change conform to methodological criteria that ensure their effectiveness. These types of studies are more complex than pure AIDS research which is aimed at finding a cure.     

Predictors of Intention to Take Precautions Against AIDS Among Black College Students1

This research explored the relationship between behavioral intentions to engage in AIDS-risky sexual practices and a variety of variables that are theoretically and/or popularly assumed to be important factors in AIDS prevention. These variables included beliefs and knowledge about AIDS, fear of AIDS, perceived vulnerability of self and others, as well as probability that self and others on one's campus would contract AIDS, perceived efficacy to control exposure to AIDS, self-esteem, general locus of control, and past behavioral reaction to the threat of AIDS. General intention to “do something to protect oneself against AIDS,” and specific behavioral intention to use condoms in vaginal sex were measured and considered as possible proxies for future behavior. Data were collected from 124 black respondents in a southeastern university. In a series of multiple regression analyses, each of these measures of behavioral intentions was “predicted” from the other variables. Results showed that situational efficacy (to protect oneself from AIDS) was the best predictor of general intention, followed by reports of past behavioral changes as a result of the AIDS epidemic, and by knowledge. Proximal fear of AIDS was a negative predictor. For specific intentions, a specific belief about inconvenience in condom use was the best predictor, followed by past behavioral change, followed by knowledge. Normative beliefs, a belief that condoms would prevent disease, and distant threat of AIDS were also significant predictors. Theoretical and policy implications of the findings are discussed.     

University students' support for heterosexual women with AIDS

Support for a woman heterosexual AIDS victim was examined among 237 university students, 54% female and 54% upper division, with a mean age of 23.7 yr. A questionnaire containing one of four scenarios (AIDS resulting from unsafe sex, unsafe drug use, sex with an unfaithful husband, or a blood transfusion) measured support by people's willingness to sign or circulate a petition supporting the victim's right to attend college classes. A five-way mixed-design analysis of variance showed that victims who took risks received less support, that respondents were more willing to sign than to circulate a petition, and, while men did not discriminate among the four scenarios, women were most likely to offer support to "innocent" victims who contracted AIDS without sexual behavior. In addition, respondents who knew someone with AIDS were more likely to sign the petition. AIDS, particularly when contracted through risky behavior, is a disease with social ramifications beyond its threat to public health.     

On Gender Specificity of Person Characteristics in Personnel Advertisements: A Study Among Future Applicants

This research is an examination of how person characteristics mentioned in personnel advertisements influence the judgments of male and female students with regard to their subjective eligibility for, and the attractiveness of, a particular vacancy. The first study showed that many frequently mentioned person characteristics in personnel advertisements applied differently to men and women, but that female characteristics were more in demand than male characteristics. The second study examined to what degree male and female participants felt that they themselves possessed male and female characteristics; results showed that the men were more confident about the degree to which they possessed male and female characteristics than the women were. The third study examined how the type of person characteristics mentioned in personnel advertisements influenced men's and women's judgments regarding their eligibility for and the attractiveness of a particular position. The men found all positions about equally attractive, whereas the women found “male” positions considerably less attractive. Implications of the study are discussed.     

Combating Homophobia in AIDS Education

Homophobia is a central theme in response to the AIDS epidemic. In this article we review literature explicating the connection between homophobia and AIDS and then call for the integration of antihomophobia elements into AIDS education. We discuss negative messages in portrayals of gay and bisexual men and in discussions of safer sexual practices, as well as materials and educational strategies that explicitly contradict such homophobic messages. We then discuss the emerging trend to exclude lesbian women and gay men in education and programs, suggest guidelines for countering such exclusion, and give examples of creative approaches to inclusion.     

A six-month follow-up of adolescents' sexual risk-taking,HIV/AIDS knowledge,and attitudes to condoms

A follow-up study was conducted to investigate change in sexual behaviour, knowledge about HIV/AIDS transmission, and attitudes to condoms over a 6-month period in a sample of late-adolescent students. The study also obtained subjective reports of HIV/AIDS-relevant change. Overall there was a decrease in sexual risk-taking behaviour with casual partners but no change occurred in sexual behaviour with regular partners, knowledge about HIV/AIDS, attitude towards condoms, or intention to use a condom on next sexual encounter. Examination of individual data revealed that, for some adolescents where behavioural change had occurred, this was in the direction of less safe sex. There were few self-reports of change in sexual behaviour, intention to take precautions against HIV/AIDS, or concern about HIV/AIDS over the preceding 6 months. Subjective reports of behaviour change did not correspond with reports of actual behaviour. Low rates of behaviour change are attributed to the failure of adolescents to personalize the threat of AIDS and to their trust in the safety of sex with a regular partner as well as to the lack of relevance of HIV/AIDS education campaigns to this group.     

Predictors of Condom Use in Mexican Migrant Laborers

The purpose of this study was to explore predictors of condom use with occasional sex partners and regular sex partners, as well as carrying condoms in a new high-risk group for HIV infection, Mexican migrant laborers. This study extends previous findings by (1) exploring additional predictors not previously examined, (2) utilizing a large sample of male and female Mexican migrant laborers, (3) carefully controlling for the effects of various demographic and lifestyle variables related to condom use, and (4) assessing the interactive effects of gender on predictors of condom use. Snowball sampling was used to survey 501 adult Mexican migrant laborers. Results revealed that condom use with occasional sex partners was predicted by carrying condoms and condom self-efficacy and that women were more likely to use condoms with occasional partners when both men and women knew someone with HIV/AIDS. Condom use with regular sex partners was predicted by procondom social norms, less negative attitudes toward condoms, not knowing someone with HIV/AIDS, and condom self-efficacy. Carrying condoms was predicted by procondom social norms, less negative attitudes toward condoms, condom self-efficacy, worry about contracting HIV/AIDS, and women were more likely than men to carry condoms when both men and women were married. Understanding these findings, future research directions, and implications for condom promotion strategies with Mexican migrant laborers are discussed.     

Selling Sex to Radio Program Directors: A Content Analysis of Radio & Records Magazine

This study was designed to examine whether radio format and musical artists' gender predict sexual content in trade advertisements geared toward radio program directors. Advertisements were coded from one of the leading music trade magazines, Radio & Records magazine, between 2002 and 2003. Results indicated that overall women artists used sexual content in trade advertisements more often and to a greater degree than did men. In some cases, advertisements in radio formats with younger demographic markets, such as pop or hip-hop, also used higher levels of sexual content. It is concluded that the organizational context of the commercial music industry helps to perpetuate status differences between women and men artists, which may then bring about a cognitive bias in the field that promotes women artists' over reliance on using sexual content in trade advertisements.     

The Effects of Fear of AIDS and Gender on Responses to Fear-Arousing Condom Advertisements

The effects of message fear arousal, fear of AIDS, and gender on attitudinal responses to condom advertisements were tested in a laboratory experiment. Ninety-five male and 96 female college students, previously assessed for fear of getting AIDS, rated the effectiveness of 1 of 4 high-fear or 4 low-fear condom ads in motivating them to buy the product. Contrary to prediction, the high-fear condom ads did not significantly differ from low-fear ads in effectiveness. The prediction that subjects' fear of AIDS would interact with ad fear level was also not supported. However, subjects with a high fear of getting AIDS viewed ads as more effective than did low-fear subjects. As predicted, male subjects viewed ads as more effective than did women. Results support the health belief model's tenet that a sense of vulnerability facilitates acceptance of a message. Implications of the results for condom use promotion in AIDS prevention materials are discussed.     

Sexual Prejudice Among Heterosexual College Men as a Predictor of Condom Attitudes

Heterosexual male college students (N?=?100) (average age?=?19.7; 43% European American; 39% Christian) from the southwestern U.S. completed surveys in order to test a model predicting condom attitudes from religiosity, gender role attitudes, sexual prejudice, and the belief that “AIDS is a gay disease.” In the final model, those who reported more religiosity, more traditional gender role attitudes, and greater anxiety about interacting with gay men also reported feeling their core values and beliefs were threatened by gay men. In turn, men who felt strongly threatened in this way more strongly endorsed the belief that “AIDS is a gay disease,” and stronger endorsement of this belief was associated with more negative attitudes about condoms and condom use.     

Belief in a Just World and Condom Use in a Sample of Gay and Bisexual Men1

Research has shown that, under certain conditions, people with a strong belief in a just world (BJW) perceive themselves to be less at risk for serious negative events (e.g., contracting AIDS). We extended this work by investigating the relation between BJW and high‐risk sexual behavior Gay and bisexual men (N= 102) responded to a questionnaire that measured individual differences in BJW, personality characteristics related to perceived relationship threat (e.g., interpersonal control), and frequency of condom use and anal intercourse. Results generally supported predictions. For example, among respondents low in interpersonal control, a strong BJW was associated with less frequent condom use. These results have implications for research on BJW, as well as research on the predictors of high‐risk sexual behavior.     

AIDS on Campus: A Preliminary Study of College Students' Knowledge and Behaviors

This preliminary study examined the possible relationship between knowledge about AIDS, subjective perception of the risk of contracting AIDS, and sexual behavior in a sample of undergraduate college students (N = 459). The majority of the students indicated that AIDS was not an issue of personal concern. Students were generally informed about AIDS, although one-third of the students were unclear about the transmission of the disease through casual contact. Data analysis indicated that no relationship existed between accurate knowledge about AIDS and sexual behavior. The relationship between self-assessment of personal risk for AIDS and reduced sexual contacts was found to be significant at the .01 level. Recommendations are made regarding AIDS educational and counseling approaches among college students. Please note that the term AIDS is used to represent the presence of HIV antibodies, AIDS-related complex (ARC), and diagnosed AIDS.     

An Analysis of Hyper-Masculinity in Magazine Advertisements

Hyper-masculinity is a gender-based ideology of exaggerated beliefs about what it is to be a man. HM consists of four inter-related beliefs, namely toughness as emotional self-control, violence as manly, danger as exciting, and calloused attitudes toward women and sex (Zaitchik & Mosher 1993). Adherence to HM is linked to a host of social and health problems in North America, such as dangerous driving and violence toward women (Parrot & Zeichner 2003). Advertising is believed to play a role in constructing hyper-masculinity (Kilbourne 1999). In this study, eight U.S. men’s magazines published in 2007–2008, differentiated by readership age, education, and household income, were analyzed for hyper-masculine depictions in their advertisements. Using a behavioural checklist with good inter-rater reliability, it was found that 56 % (n?=?295) of 527 advertisements depicted one or more hyper-masculine beliefs. Some magazines depicted at least one hyper-masculine belief in 90 % or more of advertisements. In addition, reader age, education, and income were all inversely related to the prevalence of hyper-masculine beliefs, with HM depictions presented more often in advertisements targeting young, less educated, and less affluent men. Implications of these findings for the well-being of men and society are discussed.     

Attltudes Towards AIDS and Homosexuals: Gender, Marital Status, and Religlon

The current study investigates the relationship between fear of AIDS and homophobia. The role of gender, marital status, religion, and church attendance as possible mediating variables in the hypothesized relationship was also investigated. Responses of 507 subjects to questionnaires indicated that men and women reported the same level of fear of AIDS; however, men were more homophobic than women. There was no difference between single and married individuals in the level of fear of AIDS; but people who had never been married were more homophobic than married individuals. There was also no relationship between religiosity and fear of AIDS. There were, however, differences in levels of homophobia across denominations. Finally, there was a relationship between church attendance and both fear of AIDS and homophobia. The results are compared to those obtained by Bouton and his colleagues 5 years earlier and implications for educational programs designed to change attitudes toward AIDS and homosexuality are discussed.     

The psychological impact of AIDS on gay men

The profound psychological impact of the acquired immunodeficiency syndrome (AIDS) epidemic on gay men needs to receive greater attention from mental health professionals. The specific treatment approach depends upon the individual's location on the AIDS-related conditions continuum. For men already diagnosed with AIDS, psychological themes include fears of death and dying, guilt, concerns about exposure of a homosexual life-style, fear of contagion, loss of self-esteem, decreased social support and increased dependency needs, stigmatization, loss of occupational and financial security, confusion over medical treatment options, and severe depression. The integration of a mental health service into AIDS special care hospital wards and participation in support groups are particularly useful for men with AIDS. Anxiety is the major clinical symptom among those who have not developed full-blown AIDS, but show signs of immune suppression. Issues for men in this "gray zone" include isolation, poor social and occupational functioning due to fatigue, shame, and frustration of achievement needs. Stress- reduction techniques are especially important with this population, to eliminate further compromise to the immune system or even to strengthen it. Many asymptomatic gay men ("the worried well") are manifesting acute psychological symptoms such as panic, generalized anxiety, obsessional thinking about AIDS, and somatization. Training in the negotiation of safe-sex agreements can reduce some of this anxiety. In general, the AIDS epidemic has introduced an existential component to psychotherapy with gay men, with a concern over issues such as the meaning of life and death.     

When sex doesn’t sell to men: mortality salience,disgust and the appeal of products and advertisements featuring sexualized women

Although men typically hold favorable views of advertisements featuring female sexuality, from a Terror Management Theory perspective, this should be less the case when thoughts of human mortality are salient. Two experiments conducted in South Korea supported this hypothesis across a variety of products (e.g., perfume and vodka). Men became more negative towards advertisements featuring female sexuality, and had reduced purchase intentions for those products, after thinking about their own mortality. Study 2 found that these effects were mediated by heightened disgust. Mortality thoughts did not impact women in either study. These findings uniquely demonstrate that thoughts of death interact with female sex-appeal to influence men’s consumer choices, and that disgust mediates these processes. Implications for the role of emotion, and cultural differences, in terror management, for attitudes toward female sexuality, and for marketing strategies are discussed.