PROMPTING BAR PATRONS WITH SIGNS TO TAKE FREE CONDOMS

This study was designed to determine whether signs would prompt bar patrons to avail themselves of free condoms. The intervention at three “gay bars” involved placing a large sign directly above a container of free condoms; the sign gave statistics for the number of people who have died from AIDS in the state and pointed out that condoms can reduce the spread of AIDS. Additional signs placed in the restrooms gave information about safe sex practices and reminded patrons that free condoms could be obtained at a given location in the bar. An ABAB design was used, with a 2-week baseline, 2-week treatment with signs present, 2-week reversal with no signs, and 2-week reinstatement of treatment with signs present. For all three bars combined, 748 condoms were taken with signs present and 510 condoms were taken with signs absent. Overall, when signs were present, the number of condoms taken increased by 47%.     

The effects of safer-sex stories on college students' attitudes toward condoms

Social learning theory predicts that reading non-erotic stories involving condom use will be as effective as reading erotic stories with condom use in producing positive attitudes toward condoms. Werner's orthogenetic principle, however, predicts that reading erotic condom stories will be most effective because of the link created between sexual arousal and cognitive information about condoms. 168 male and 149 female undergraduates enrolled in Introductory Psychology at a small, private, southern university participated in a study to test the validity of these two theories. The students read one of the following types of stories: erotic with condom placement described, erotic without condom use, or non-erotic with a model for discussing condoms. The men and women who read the non-erotic stories were most positive about condoms and reported the strongest intentions to use condoms in the future. These findings suggest that erotica is not necessary to produce positive attitudes toward condoms.     

What’s in a Purse? Maybe a Woman’s Reputation

Does a woman’s reputation suffer when others discover condoms in her possession? Fifty-two male and female predominantly white undergraduates from a small, private, Catholic university in the northeast USA examined the contents of a purse to formulate an impression of its owner. Unflattering inferences were drawn about the character of the target when her purse contained condoms. A follow-up study with 55 comparable participants confirmed that these inferences were indeed uncomplimentary. The results are discussed in terms of the multi-dimensional price women pay when assuming responsibility for their sexual health.     

The relationship between psychosocial factors and condom use among African-American adolescents

The present investigation explored the relationship between psychosocial factors and condom use by African-American adolescents. Two hundred twenty-nine males, aged 14 to 19 years, responded to a health behavior survey that gathered information on demographics, HIV knowledge, perceived certainty of future condom use, present and past use of condoms, and intention to use condoms in the next six months. Several psychological variables, including sexual self-efficacy and self-esteem, were also measured. It was found that the majority of participants were sexually active by age 13, had four or more lifetime sexual partners, and were using condoms regularly. Multiple linear regression analysis indicated that sexual self-efficacy predicted perceived certainty of condom use. In addition, self-esteem and sexual self-efficacy predicted intention to use condoms. These findings highlight the need to develop HIV prevention curricula for African-American male adolescents that not only emphasize the potential risks associated with having multiple sexual partners, but also include components to enhance self-worth and sexual self-efficacy.     

‘Sluts’ or ‘Sleazy Little Animals’?: Young People's Difficulties with Carrying and Using Condoms

Qualitative data from a Western Australian study of sexual behaviour in young people were used to describe difficulties experienced in carrying and using condoms. Both men and women were concerned for their sexual reputation if they carried condoms, although this was more of a problem for the women than the men. However, these fears were not matched by the attitudes of the opposite gender: in general, there was less negativity about condom-carrying than was feared. Many of those who described using condoms had experienced condom failure and other difficulties, and it appeared that they were unfamiliar with the correct way to use condoms. It is suggested that many of these barriers to condom use can be removed with appropriate education and information strategies.     

Women,men, and condoms: attitudes and experiences of heterosexual college students

Little is known concerning gender and ethnic differences in attitudes about condoms or about the impact of attitudes on condom use. College students ( N = 393) rated many features of condoms. Overall, students were mildly positive about condoms, believing they offer effective protection but detract from sexual sensation. Both past condom use and future intentions to use condoms were higher among students with more favorable global attitudes toward condoms and more favorable specific beliefs about the interpersonal dynamics of condom use. Future intentions to use condoms were also associated with greater worry about sexually transmitted diseases and fewer previous sexual partners. Women were more favorable toward condoms than men. Gender differences also emerged in the predictors of condom use. Implications for assessing condom attitudes and for increasing condom use among young heterosexuals are discussed.     

Brief counseling to reduce AIDS risk in intravenous drug users and their sexual partners: Preliminary results

Intravenous drug users (N = 88) and their sexual partners (N = 45) were randomly assigned to either a brief counseling intervention or an information-brochure only condition (aimed at reducing behavioral risk for HIV infection). At 10 day follow-up, intravenous drug users exposed to brief counseling were more knowledgeable about risk behaviors, and reported higher levels of self-efficacy and communication skill, and more frequent use of condoms and sterilisation of needles. At 90 day follow-up, intravenous drug users were more accepting of guidelines to reduce sex-related risk and reported greater self-efficacy in relation to drugs. Sexual partners who received brief counseling showed a small reduction in unprotected sex (at 90-day follow-up), while those receiving brochures were slightly less likely to use condoms. Methodological problems of the study are discussed.     

Differences Between Condom Users and Condom Nonusers in Their Multidimensional Condom Attitudes

In two studies, we examined multidimensional condom attitudes of college students separately for (a) condom users vs. condom nonusers, (b) women vs. men, and (c) partnered individuals vs. single individuals (Study 1). Almost all single people (97%) expected to use condoms during each incident of sexual intercourse during the next 2 months. Across both studies, condom users were distinguished from nonusers by the attitude that condom use would interfere with sexual pleasure, and by skepticism that they would be able to use condoms in the face of obstacles (i.e., the action-maintenance dimension of condom attitudes). These effects held for expected future condom use, as well as current condom use. One gender difference also emerged across both studies: Men were more concerned about condoms interfering with sexual pleasure than were women. Implications for condom-use promotion are discussed.     

College Women and Condom Use: Importance of Partner Relationship

Because women who want to use condoms as protection against STDs must gain compliance from their male partners, women's use of condoms was examined within the context of their relationships with their sexual partners. Sexual history, condom attitudes, and relationship information were gathered from a sample of 272 heterosexual college women. For the 121 women with a current sexual partner, logistic regression analyses revealed that both regular condom use and completely consistent condom use were more likely in shorter relationships and for women who perceived lower barriers to use. Regular condom use was also greater in relationships described as high in trust, whereas consistent condom use was greater for women in their first sexual relationships. In addition, many women reported using condoms early in their relationships, but changing to lower levels of use later. Implications of the current findings for safer-sex interventions are discussed.     

The Moderating Role of Self-Efficacy Beliefs in the Relationship Between Anticipated Feelings of Regret and Condom Use1

This prospective study examined how the feelings of regret and self-blame one anticipates after engaging in unsafe sex affect condom use in new sexual relationships. The central theoretical question is whether self-efficacy perceptions can moderate the relationship between anticipated feelings and actual condom use. Consistent with theories of anticipated regret and social cognitive learning, participants were most likely to use condoms between the first and second waves of data collection when they anticipated negative feelings as a result of not using condoms (and positive feelings after having used condoms), particularly when they also believed that they had the power to exercise control over the sexual situation (high self-efficacy). The implications for interventions aimed at promoting safer sex are discussed.     

Ambivalence and Unprotected Sex: Failure to Predict Sexual Activity and Decreased Condom Use1

Using a prospective design, we assessed whether ambivalence toward sexual activity is associated with decreased condom use. Undergraduates predicted whether they would have intercourse and use condoms in the next week. A week later, they reported their sexual and contraceptive behavior. Among 65 individuals who had intercourse and planned to use condoms, ambivalence toward sexual activity was negatively associated with condom use. Moreover, whether intercourse was planned mediated the relationship between ambivalence and condom use, such that ambivalence was negatively associated with accuracy in planning sex, and unplanned sex was less likely to be protected. Individuals who are ambivalent about sex may intend to use condoms, but fail to do so because they cannot predict when they will have intercourse.     

Health beliefs and teenage condom use: a prospective study

The authors investigated the extent to which Health Belief Model (HBM) measures can be used to predict subsequent sexual activity and consistency of condom use among teenagers, especially those who report having new sex partners. Results from a longitudinal survey of sex behavior and HIV-relevant cognitions among 258 sexually active 16 and 18 year olds in Dundee, Scotland, are reported. Participants responded to a confidential postal questionnaire on their demographic characteristics, previous sexual experience, prior condom use, beliefs specified by the HBM, peer norms regarding condom use, and condom use intentions. Measures of sexual behavior and condom use consistency were then included in a follow-up questionnaire 1 year later. Demographic and HBM measures, as determined through discriminant analysis, did not account for significant proportions of variance in the consistency of condom use or mediate the effects of prior sexual experience or demographic measures. The respondents who reported more frequent sexual intercourse were less likely to use condoms consistently while those who had used condoms previously reported more consistent use. Female respondents were less likely than the young men to follow through upon their intentions to consistently use condoms.     

The prediction of condom use intention among South African university students

A questionnaire was administered to 294 sexually active, unmarried undergraduate students to investigate the role of social norms in the prediction of the intention to use condoms. Components of social cognitive theory and the theory of reasoned action and planned behaviour were integrated with those of the Health Belief Model to predict future intention to use condoms with a new partner. Logistic regression analyses of selected risky sexual behaviours on the intention to use condoms showed that, among males, attitudes towards using condoms and the Health Belief Model component of perceived barriers predicted the intention to use condoms. The Health Belief Model component of perceived benefits could not be interpreted. Attitudes, subjective norms and perceived self-efficacy were associated with female students' intention to use condoms. Implications for strategies of HIV/AIDS prevention are discussed.     

Transmission risk behaviors in a subset of HIV-positive individuals: The role of narcissistic personality features

Most people living with HIV/AIDS (PLWHA) take steps to protect their sexual partners. However, a minority of PLWHA continue to engage in sexual risk behaviors that might contribute to the transmission of HIV. Psychiatric conditions, including certain pathological traits, are associated with sexual risk behaviors. Research examining the association between narcissistic traits as they relate to HIV transmission risk is limited. In the present study, 303 PLWHA were recruited from an infectious disease clinic and completed questionnaires assessing narcissistic characteristics, substance use, sexual risk behavior, and intentions to use condoms in the future. Narcissistic traits predicted unprotected sex with partners who are HIV-negative or whose HIV status was unknown as well as lower intentions to use condoms, after controlling for demographic factors and substance use. Interventions focused on reducing the transmission of HIV should take into account associations between sexual risk behavior and narcissism.     

Social Dominance Orientation Relates to Believing Men Should Dominate Sexually, Sexual Self-Efficacy, and Taking Free Female Condoms Among Undergraduate Women and Men

Gendered-based power affects heterosexual relationships, with beliefs in the U.S. prescribing that men dominate women sexually. We draw on social dominance theory to examine whether women??s and men??s level of support for group-based hierarchy (i.e., social dominance orientation; SDO) helps explain gender-based power beliefs and dynamics in heterosexual relationships. We conducted a laboratory study at a Northeastern U.S. university among 357 women and 126 men undergraduates who reported being heterosexual and sexually active, testing three sets of hypotheses. First, as hypothesized, women endorsed SDO and the belief that men should dominate sexually less than men did. Second, as hypothesized, among women and men, SDO was positively correlated with the belief that men should dominate sexually, and negatively correlated with sexual self-efficacy (confidence in sexual situations) and number of female condoms (a woman-controlled source of protection) taken. Third, structural equation modeling, controlling for age, family income, number of sexual partners in the past month, and perceived HIV/AIDS risk, supported the hypothesis that among women and men, the belief that men should dominate sexually mediates SDO??s association with sexual self-efficacy. The hypothesis that the belief that men should dominate sexually mediates SDO??s association with number of female condoms taken was supported for women only. The hypothesis that sexual self-efficacy mediates SDO??s association with number of female condoms taken was not supported. Results suggest SDO influences power beliefs and dynamics in heterosexual relationships. Although female condoms are an important woman-controlled source of protection, power-related beliefs may pose a challenge to their use.     

Twenty years of student sexual behavior: subcultural adaptations to a changing health environment

This twenty-year study analyzes changes in sexual behavior among students at Okanagan University College in British Columbia, Canada. Surveys conducted in 1980, 1990, and 2000 reveal a steady increase in safer sexual practices. Most students now question potential partners about their past, use condoms with a new sexual partner, and maintain fairly long-term monogamous relationships. Three sexual subcultures continue to coexist in fairly stable proportions: celibacy (about 30%), monogamy (about 60%), and free experimentation (about 10%). Each subculture has created its own response to the danger of HIV/AIDS: celibates exaggerate the danger they face, monogamists rely on love and fidelity for protection, and free experimenters have increased their use of condoms. While romantic feelings lead many monogamous couples to abandon condoms without objective HIV/AIDS knowledge, free experimenters still face the highest risk. Although they now use condoms more than half the time, their lifestyle, which involves multiple partners, risky sexual acts, and frequent drug and/or alcohol use, clearly remains dangerous. The persistence of distinct subcultures has implications for health education programs, which would be most effective if based on key values held by specific target groups.     

Risk profiles of adolescent girls who were victims of dating violence

The prevalence of dating violence, as well as its relationship to potential risk factors, was examined among a nationally representative sample of 9th-through 12th-grade U.S. females (N = 7,824) who completed the 1999 Youth Risk Behavior Survey. The dependent variable was physical dating violence; the independent variables were violence, suicide, substance use, and sexual risk behavior. Unadjusted odds ratios (OR) and 95% confidence intervals were examined, and multivariate logistic regression analysis was conducted to identify the most significant risk factors. It was found that nearly one in ten of the adolescent girls reported dating violence. Twelfth-grade girls had the highest prevalence of dating violence. Girls who were victims of dating violence were more likely to be involved in other violent behaviors, to report extreme sadness and suicidal actions, to use illicit substances, and to engage in risky sexual behavior. Multivariate analysis revealed that dating violence was associated with sad/hopeless feelings (OR = 2.13), binge drinking (OR = 1.96), cocaine or inhalant use (OR = 2.90), multiple sex partners (OR = 2.38), nonuse of condoms (OR = 1.53), and ethnicity, specifically being Black (OR = 2.32) or Hispanic (OR = 1.82). These findings provide further evidence that there is a clustering of risk factors among certain adolescents, specifically girls who experience dating violence.     

Intention, Context, and Safe Sex: Australian Adolescents' Responses to AIDS

This study examined the applicability to condom use of Ajzen and Madden's (1986) theory of planned behavior by examining the predictors of intention to use a condom and actual condom use in a specific sexual situation. In a sample of 144 sexually active heterosexual males and females, limited support was found for the model. Intentions to use a condom immediately before a particular sexual encounter, and those assessed some time prior to this encounter were found to have direct and positive effects on condom use. In addition, perceptions of the disadvantages of condoms (a measure of attitudes to condoms in general) had direct negative effects on condom use and, together with perceptions of the advantage of condoms, also had indirect effects on condom use via prior intention. A number of the postulated predictors of safe sexual practice related neither to intentions nor behavior. The contextual variables of sexual arousal, condom availability, and degree of communication with a sexual partner all influenced condom use. Discussion centered on first, differences in the predictive ability of the model when compared to other studies of planned behavior, and second, the factors limiting the relationship between intention and behavior when the behavior in question is not under complete, volitional control.     

Determinants of intentions to practise safe sex among 16–25 year-olds

This study aimed at predicting intentions to avoid casual sex and to use condoms, through self-efficacy, attitudes, optimistic bias in perceived risk, knowledge and past sexual risk behaviour. To this end, a mixed-sex sample of high school and university students between 16 and 25 years completed questionnaires at two points in time. Intentions to avoid casual sex were predicted positively by the attitude towards avoiding casual sex and assertiveness in sexual relationships, and negatively by communication about sex. The intention to use condoms was predicted positively by the perceived benefits of condom use, and negatively by past sexual risk behaviour and fatalism. Gender and sexual experience were found to have a moderating influence, implying that AIDS education should use different messages for these target groups. Since the results show that condom use is quite a powerful habit and that sexually non-active subjects had more positive intentions towards safe sex, AIDS education should start at a young age in order to establish safe sex habits from the beginning. © 1997 John Wiley & Sons, Ltd.