The effects of ethnicity and perceived power on women's sexual behavior

To aid development of programs to prevent HIV transmission in women, differences in sexual attitudes and behavior were examined among women who described themselves as dominant in their relationship with a male partner, sharing dominance equally with a male partner, or being dominated by a male partner. Ethnic differences were also examined among these three groups. Results indicated that perceived dominance was a significant predictor of women's personal empowerment (self-efficacy and outcome expectancies) with regard to sexual decision-making in their current relationship and safer sex behaviors. Ethnic differences were found between African American and White women in personal empowerment and safer sex behavior. Perceived dominance did not appear to affect African American and White women differently.     

Predicting Zimbabwean women's ability to tell their partners to use condoms.

The effectiveness of AIDS education may depend on the development of models that predict and explain HIV prevention behavior. In this study, the aim was to test Fishbein and Ajzen's theory of reasoned action model in predicting women's capacity to tell their partner to use condoms. The basic theory pertains to the relationship of 1) attitude toward behavior and 2) the subjective norms to behavior; further refinements reflect factors such as 3) perceived behavioral control or self-efficacy, 4) and perceived barriers. A sample was drawn of 123 female first-year teacher trainees in Harare, Zimbabwe, in late 1990; a self-administered questionnaire was distributed and returned. 72% of the respondents were sexually experienced. The mean age of the entire sample was 24 years. The results of the multiple linear regression indicated that the model was able to predict were F(2,74)=32.81, p.0001. 47% of the variance was explained by this Fishbein model. Attitude toward behavior was significantly associated with the intention to tell one's partner to use condoms (beta = .60, p .05). Subjective norms were not significant (beta = .15, p .05). Perceived behavioral control and perceived barriers were also not significantly associated with the intention to tell one's partner to use condoms. A caveat was that the subjective norm was measured by only one item, and an improved conceptualization and measurement of this construct might have changed the relationship. The suggestion is that health educators should address women's underlying beliefs and attitudes about the benefits of telling their partners to use condoms. Future prospective studies will better delineate the relationship between attitude and behavior.     

Gender Roles,Power Strategies,and Precautionary Sexual Self-Efficacy: Implications for Black and Latina Women's HIV/AIDS Protective Behaviors

This cross-sectional study tested a conceptual model of women's HIV/AIDS protective behaviors using gender roles, relationship power strategies, and precautionary sexual self-efficacy as predictors in a predominantly Black and Latina community sample of heterosexual women (N = 125). Results revealed no support for the full model, but partial confirmation for several components of the model. Education significantly predicted gender roles, and gender roles and use of direct power strategies were significant predictors of sexual self-efficacy. Most of the participants were married or partnered and were unconcerned about contracting HIV, suggesting that if women perceive that they are at low or no risk, their gender roles, power strategies, and precautionary sexual self-efficacy will be inconsequential to their HIV/AIDS risk reduction practices.     

Sex Differences in Social Support and Self-Efficacy Within a Recovery Community

This study examined similarities and differences in social support and self-efficacy for abstinence between women and men recovering from substance addiction. The sample consisted of 87 residents of Oxford House (OH) self-run, community-based recovery homes. Analyses revealed similarities between women and men in terms of the composition and utilization of support networks and abstinence self-efficacy. Also, for both sexes, length of residency in OH was significantly related to decreased social support for alcohol and drug use and increased self-efficacy for abstinence. However, multiple-group SEM analyses demonstrated that social support for alcohol/drug use fully mediated the link between length of residency and abstinence self-efficacy for women, but not for men. Findings suggest that the process of gaining self-efficacy to remain abstinent is distinct for women and men, and that social support plays a different role in women's recovery than it does in men's.     

Relation of Self-Efficacy to Reported Pain and Pain Medication Usage During Labor

We studied the relationship of self-efficacy to reported labor pain and pain medication usage among 43 women. Self-efficacy ratings were judgments of confidence regarding successful completion of tasks involved in labor and delivery (e.g., doing breathing exercises) and in overcoming barriers (e.g., nonsupportive partner). Multiple regression analyses revealed that self-efficacy significantly contributed to predicting labor pain beyond other relevant variables (e.g., age, amount of menstrual pain), with barrier self-efficacy the strongest predictor. Results are discussed in the context of increasing women's confidence in overcoming barriers by incorporating relevant interventions in childbirth education.     

Integration of five health behaviour models: common strengths and unique contributions to understanding condom use

The purpose of this research was to select from the health belief model (HBM), theories of reasoned action (TRA) and planned behaviour (TPB), information-motivation-behavioural skills model (IMB) and social cognitive theory (SCT) the strongest longitudinal predictors of women's condom use and to combine these constructs into a single integrated model of condom use. The integrated model was evaluated for prediction of condom use among young women who had steady versus casual partners. At Time 1, all constructs of the five models and condom use were assessed in an initial and a replication sample (n?=?193, n?=?161). Condom use reassessed 8 weeks later (Time 2) served as the main outcome. Information from IMB, perceived susceptibility, benefits, and barriers from HBM, self-efficacy and self-evaluative expectancies from SCT, and partner norm and attitudes from TPB served as indirect or direct predictors of condom use. All paths replicated across samples. Direct predictors of behaviour varied with relationship status: self-efficacy significantly predicted condom use for women with casual partners, while attitude and partner norm predicted for those with steady partners. Integrated psychosocial models, rich in constructs and relationships drawn from multiple theories of behaviour, may provide a more complete characterisation of health protective behaviour.     

Perceived social support, self-efficacy, and adjustment to abortion

Prior to their having a 1st trimester abortion, women's perceptions of social support from their partner, family, and friends and self-efficacy for coping were assessed. Depression, mood, physical complaints, and anticipation of negative consequences were measured after the 30-min recovery period. As predicted, perceived social support enhanced adjustment indirectly through its effects on self-efficacy. Women who perceived high support from their family, friends, and partners had higher self-efficacy for coping. Higher self-efficacy, in turn, predicted better adjustment on the psychological measures but not on the physical complaint measure. No direct path between social support and adjustment was observed. In addition, women who told close others of their abortion but perceived them as less than completely supportive had poorer postabortion psychological adjustment than either women who did not tell or women who told and perceived complete support.     

Self-Efficacy to Use Condoms in Unmarried Latino Adults

Measures of self-efficacy to use condoms can clarify the barriers to condom use Latinos encounter. A 20-item scale, that differed slightly for men and women, and was based on extensive elicitation interviews, was used in a random digit dial household survey of 1,600 unmarried Latino adults in 10 states with large Latino populations. Self-efficacy was related to condom use for both men and women. Factor analyses revealed five correlated factors: Regular Partner, Impulse Control, Partner Resistance, STD Thoughts, and Condom Discussion. Both men and women reported lowest self-efficacy for impulse control and using condoms with a regular partner. Less-educated men and women had lower self-efficacy to discuss condoms, to manage partner resistance, to use condoms with a regular partner, and to control impulses, but there were few other demographic differences in self-efficacy. The scale can be helpful in the design and evaluation of HIV prevention.     

Women's Sexual Health: The Need for Feminist Analyses in Public Health in the Decade of Behavior

Women's sexual health is directly affected by women's low status in society. This low status, and subsequent lack of sexual autonomy, not only increases risk for sexual health problems, it also decreases ability to obtain treatment and support when a sexual health concern arises. This has clearly been demonstrated in the HIV epidemic within the U.S.. Earlier in the epidemic, women were simply ignored by public health research and practice. Once they could no longer be ignored, they were blamed and viewed as vectors. Current seroprevalence rates among men reveal that women are not significant vectors. In contrast, rates among women indicate that infection from men is the primary mechanism by which women are contracting HIV, and male-controlled sexual decision-making, male partner violence against women, and histories of sexual assault all contribute to increased HIV risk for women. Once infected, women are not given the support and resources they need as mothers and caretakers of HIV-positive partners and/or children. These findings are especially true for marginalized women such as women of color, poor women, women addicted to alcohol or drugs, and women who exchange sex for drugs or money. Findings from this review demonstrate the need for feminist approaches in understanding and addressing this issue in the Decade of Behavior. Such approaches must include an understanding of the needs of diverse women. An empowerment approach is needed to better contend with the sexual health needs of women; this must include the goal of ensuring women's control of their own bodies.     

Exploring the Relationship Between Positive Work Experiences and Women's Sense of Self in the Context of Partner Abuse

In this study we examined the relationships among partner abuse, work quality, and women's sense of self. In particular, we explored the potential for women's work to serve as an alternative source of feedback for the self in the context of partner abuse. The sample consisted of 100 working women who reported experiencing a range of partner abuse. Relationships among partner abuse, work quality, and three self constructs were tested using multivariate multiple regression. Work quality was significantly and positively associated with self at work and general self-esteem and approached significance for self at home. There were no significant associations between partner abuse and self at work. Partner abuse was negatively and significantly associated with self at home and approached significance for self-esteem. These varied results support the importance of assessing multiple aspects of the self and the potential of women's work to be a resource in the context of partner abuse.     

The role of illicit substance use in a conceptual model of intimate partner violence in men undergoing treatment for alcoholism

Illicit substance use (ISU) predicts intimate partner violence (IPV) above and beyond alcohol use and other known IPV correlates. Stuart and colleagues (2008) provided evidence for a theoretical framework by which ISU contributes both directly and indirectly to IPV. We sought to replicate and extend their findings using data from 181 married or cohabiting heterosexual couples in which the male had recently begun a substance abuse treatment program and met criteria for alcohol dependence (97%) or abuse (3%). Using SEM, we found that (a) Stuart et al.'s model provided a good fit to the data; (b) men's cocaine use and women's sedative use emerged as particularly relevant to their respective perpetration of IPV; (c) a positive association between men's antisociality and physical aggression was mediated by increased stimulant use; and (d) the specific pattern of IPV predicted by women's sedative use differed across levels of aggression severity. These findings not only highlight the direct role of ISU in relationship aggression, but also support a larger theory-driven model comprising various proximal and distal precursors of IPV.     

Psychosocial predictors of gay men's AIDS risk-reduction behavior.

Used psychosocial variables derived from the health belief model (Rosenstock, 1974), Bandura's (1986) self-efficacy framework, and protection motivation theory (Rogers, 1984) to predict self-reported AIDS risk-reduction behaviors in a sample of 389 homosexual men who participated in the Multicenter AIDS Cohort Study in Los Angeles and who knew their HIV antibody status. Hierarchical multiple regression analyses showed that self-efficacy, perceived risk, response efficacy, and prior sexual behavior accounted for approximately 70% of the variance in the total number of sexual partners and the number of anonymous partners over a 6-month interval, controlling for demographic variables, HIV antibody status, and presence of a primary partner. A logistic regression analysis showed that barriers to change predicted increased unprotected anal receptive intercourse over a 6-month interval, controlling for prior behavior. The relation of health beliefs to risk-reduction behavior was substantially different for HIV-seropositive men without primary partners than for other groups of gay men. Implications for interventions are discussed.     

Relationship commitment and its implications for unprotected sex among impoverished women living in shelters and low-income housing in Los Angeles County.

OBJECTIVE: To examine how relationship commitment among impoverished women is associated with their frequency of unprotected sex. DESIGN: Cross-sectional analyses were conducted on survey data from a probability sample of 445 women initially sampled from shelters and low-income housing in Los Angeles County. MAIN OUTCOME MEASURE: Frequency of unprotected sex in a typical month was derived as the product of 2 items: how often the woman had sex with her partner in a typical month and how often a male condom was used. RESULTS: For both sheltered and housed women, relationship commitment predicted more frequent engagement in unprotected sex with their partner, even after controlling for the type of relationship (primary vs. casual). However, this association could not be accounted for by perceived partner monogamy, ability to refuse unwanted sex, perceived HIV susceptibility, and condom use self-efficacy. Among housed women only, never asking the partner to use a condom partially accounted for more frequent engagement in unprotected sex among women with stronger relationship commitment. CONCLUSION: Results emphasize the importance of relationship commitment issues in HIV prevention interventions with impoverished women, and the need for a better understanding of relationship commitment and its influence on condom use in this population.     

Alcohol use and high-risk sexual behavior among men who have sex with men: the effects of consumption level and partner type.

Alcohol use may increase HIV sexual risk behavior, although findings have varied across study populations and methods. Using event-level data from 1,712 seronegative men who have sex with men, the authors tested the hypothesis that social context would moderate the effect of alcohol consumption on unprotected anal sex (UAS). For encounters involving a primary partner, rates of UAS did not vary as a function of alcohol use. However, consumption of 4 or more drinks tripled the likelihood of UAS for episodes involving a nonprimary partner. Thus, the effects of alcohol vary according to the context in which it is used. Interventions to reduce substance-related risk should be tailored to the demands of maintaining sexual safety with nonprimary partners.     

Predictors of Condom Use Among African American Males at High Risk for HIV1

This study compared the influence of HIV risk behaviors and condom use attitudes on condom use among heterosexual African American males. Three models were tested: (a) HIV risk, (b) condom use attitudes, and (c) a model combining the previous two. Brief street intercept interviews were administered to African American males in 2 matched pairs of census tracts. Results are based on 589 males reporting vaginal sex in the last 30 days. The General Linear Test (GLT) was used to test the ability of regression models to reduce error variance. The condom use, attitude model was sufficient to predict frequency of condom use regardless of partner type. The strongest predictors of condom use were condom use enjoyment, social norms, self-efficacy, and social influence.     

Internalizing and externalizing dimensions and alcohol use in first time DWI offenders: indirect effects through coping self-efficacy

Using cross-sectional data and structural equation modeling, we evaluated whether coping self-efficacy to abstain from drinking in various situations accounted for the relationship between internalizing (depression, anxiety) and externalizing (aggression, low socialization) dimensions with problematic alcohol use in 292 first-time DWI offenders. Results indicated that an internalizing dimension indirectly predicted problematic alcohol use through coping self-efficacy in negative situations only, whereas an externalizing dimension indirectly predicted problematic alcohol use through coping self-efficacy in positive situations only. These findings support two potential pathways to problematic drinking behavior among DWI offenders and suggest that internalizing and externalizing dimensions may differentially predict high risk drinking situations due to one's inability to abstain in specific situations.     

Intimate partner violence and alcohol use: Exploring the role of drinking in partner violence and its implications for intervention

A large and growing empirical literature reveals a robust relationship between alcohol use and the occurrence of intimate partner violence (IPV). However, the role of alcohol use and intoxication in episodes of IPV, particularly with respect to alcohol's potential causal or facilitative function in the occurrence of partner aggression, remains a source of much controversy and considerable debate. The purpose of this review is to (a) describe briefly IPV and the types of behaviors subsumed under this label, (b) examine evidence for the link between alcohol use and IPV, (c) explicate factors (e.g., antisocial personality disorder) that may moderate this relationship, and (d) discuss the primary conceptual models put forth to explain this association. Recommendations for interventions that consider the relationship between alcohol use and IPV are also provided.     

Book review of The psychology of eating. J. Ogden. Oxford: Blackwell publishing, 2003. i–xii + 302 pages ISBN 0-631-23373-3 (hbk) 0-631-23374-1 (pbk)

Abstract

This study examined the importance of the nature of the relationship between sexual partners in predicting types of sexual practices for 293 gay and bisexual men. Demographics, personal beliefs, substance use, and variables from the health belief model, theory of self-efficacy, and theory of reasoned action were used to predict sexual behaviors. Sexual practices varied by type of partner relationship and duration, with a higher probability of risky behaviors occurring with primary partners than with non-primary partners; relationship status also moderated the effects of safer sex partner norms and denial on sexual risk-taking. In addition, men who were younger, had less education, and used alcohol or drugs prior to sex engaged in higher risk behaviors. This study indicates that a more comprehensive assessment of dimensions of partner relationship will lead to greater understanding of sexual risk-taking.     

Having “The Talk”: Individual,Family, and Partner Factors on Unprotected Sex among Female Adolescent Offenders

This study assessed the influence of individual age and substance use, family support and communication, and partner support and communication on the frequency of unprotected sex among incarcerated adolescent females. Subjects (n = 273) completed a survey on psychosocial correlates and risk behaviors for sexually transmitted infections (STI). Communication with male partners and sex while under the influence have a significant impact on condom use. Findings highlight the necessity of providing assertive communication skills training and increasing self-efficacy as STI/HIV prevention components for adolescent females thus empowering their decision-making processes.     

Sexual willingness with same- and other-sex prospective partners: Experimental evidence from the bar scene

Sex is ubiquitous in the media, but only a fraction depicts sexual interactions between same-sex partners. This field study, conducted outside of bars in the Midwestern United States, examined 83 heterosexuals’ sexual willingness with a same- or other-sex partner. Participants viewed a randomly assigned video vignette of a same- or other-sex partner. Alcohol intake, partner attractiveness, and sexual willingness were measured. Using moderated regression analysis, we found that alcohol intake predicted sexual willingness with the male target for both men and women, but not with the female target. The attractiveness of same-sex partners was related to sexual willingness. Sexual willingness was only influenced by alcohol intake and perceived attractiveness of a same-sex prospective partner. Most notably, alcohol intake was related to increased sexual willingness of men with a same-sex partner, suggesting a potential shift in normative casual sexual behavior among heterosexual men.