计划行为模型在HIV性风险行为领域的应用与发展*

整理和回顾了计划行为模型在HIV性风险行为领域的应用与进展。该模型在不同文化背景、不同样本中,对于HIV性风险行为呈现良好的解释力,但是其整体预测力及内部变量的显著程度仍不时波动。21世纪以来,通过核心变量操作化、新变量引入和结构关系调整,模型获得了较大的扩展和完善。但在模型效度再检验、纳入社会性别视角、克服个体行为模型缺陷,以及强化模型的干预适用性方面仍有较大的发展空间     

The Role of Male Sexual Partners in HIV Infection Among Male-to-Female Transgendered Individuals

SUMMARY

Male-to-female transgendered persons (MtF) in San Francisco have very high HIV prevalence and incidence. To explore possible sources for these high rates of HIV infection, a rapid needs assessment was conducted using two methods: (1) an interviewer-administered, mostly closed-ended survey with the male partners of MtF persons, and (2) focus groups with MtF persons. Five main themes were evident from the findings: (1) male partners of MtF persons are of all ages, races, sexual orientations, and socioeconomic backgrounds; (2) high-risk sex occurs between MtF persons and their male sexual partners, despite a high level of concern about HIV among both the male and MtF study participants; (3) drug use appears to play a role in unsafe sex between MtF and their male partners; (4) male partners of MtF persons may represent a possible bridge for HIV transmission among different populations, given that they reported sex with male and female partners, as well as transgendered partners; and (5) men engaging in receptive anal sex with MtF partners probably occurs more frequently than reported by the male participants, given the comments of MtF study participants. The results indicate a need for creative, community-based HIV prevention strategies that target the male partners of MtF transgendered persons.     

Diverse Phases of Collaboration: Working Together to Improve Community-Based HIV Interventions for Adolescents

Although alliances between community-based organizations (CBOs) and university-based evaluators provide opportunities to enhance community-based interventions, such partnerships may be fraught with challenges and obstacles. This paper focuses on the "story" behind a collaborative partnership between a Latino-focused CBO and a team of university-based evaluators that was formed to evaluate HIV prevention interventions for Mexican American female adolescents and gay/bisexual/questioning (GBQ) Latino male adolescents. A developmental trajectory of the partnership is detailed, with a focus on the creation and enhancement of a reciprocal and mutually beneficial relationship. In tracing this history, the paper explores challenges that were faced and presents ways in which the partnership attempted to overcome obstacles. Recommendations are offered to assist in the formation and maintenance of collaborative partnerships between CBOs and university-based evaluators/researchers.     

保护动机对农村流动人口性病艾滋病高危性行为的预测

农村流动人口已经成为我国性病艾滋病预防干预的重点人群。为了探讨流动人口所存在的性病艾滋病高危性行为,以及保护动机（Protection Motivation）对性病艾滋病高危性行为的预测作用,研究选取2201名从农村到北京打工已有3个月的流动人口为被试,采用问卷调查的形式,要求其报自己报告初始性行为发生的时间、性伙伴的数量、商业性行为、性伙伴的性行为、安全套的使用,对我国性病艾滋病严重程度的评估,以及所拥有的性病艾滋病症状知识和传播知识。对904名已发生性行为的流动人口的统计分析发现：（1）农村流动人口存在较多的高危性行为,男性流动人口的高危性行为明显多于女性流动人口;（2）保护动机理论对农村流动人口的性病艾滋病高危性行为具有明显的预测作用,其中的外在奖励、内在奖励、反应效能和反应代价与农村流动人口的性病艾滋病高危性行为的关系更为密切。研究揭示,保护动机理论可以作为我国今后开展农村流动人口性病艾滋病高危性行为预防干预工作的一个基础     

Development and Refinement of a Targeted Sexual Risk Reduction Intervention for Women With a History of Childhood Sexual Abuse

Childhood sexual abuse (CSA) is associated with sexual risk behavior in adulthood. Traditional sexual risk reduction interventions do not meet the unique needs of women who have been sexually abused. In the current paper, we describe the four-stage process we followed to develop and refine a targeted sexual risk reduction intervention for this population. First, initial quantitative work revealed that the intervention should address how maladaptive thoughts related to traumatic sexualization, trust, powerlessness, and guilt/shame (traumagenic dynamics constructs) influence current sexual behavior. Second, qualitative interviews with 10 women who reported a history of CSA (M age = 34 years; 90% African American) as well as current sexual risk behavior provided support for targeting maladaptive thoughts associated with these traumagenic dynamics constructs. Third, based on the qualitative and quantitative results, we developed a 5-session, group-delivered intervention to address the maladaptive thoughts that occurred as a result of CSA, as well as the cognitive-behavioral determinants of sexual risk behavior. This intervention drew heavily on cognitive behavioral techniques to address cognitions associated with CSA and the links between these cognitions and current sexual risk behavior. Techniques from trauma-based therapies, as well as motivational techniques, were also incorporated into the intervention. Finally, we refined the intervention with 24 women (M age = 33 years; 79% African American), and assessed feasibility and acceptability. These women reported high levels of satisfaction with the intervention. The resultant intervention is currently being evaluated in a small, randomized controlled trial.     

Treating Anti-social Behavior in Adolescents: A Comparison of Multi-modal and Psychodynamic Oriented Group Interventions

This study compared the efficacy of a multimodal intervention (MMI) and a psychodynamic oriented group intervention (POGI) on antisocial behavior among Nigerian adolescents. A pretest-posttest design was used. Forty-one adolescents drawn from the streets of a Nigerian city (N =20), and a state child correction facility (N=21) participated in the study. The children were randomly assigned to a MMI, POGI and waiting list control (WLC) groups. Ages ranged from 10 to 18 years (mean =14.5; SD=2.1). Data collected were analyzed using multiple group comparison procedures. Results showed that MMI significantly reduced self-reported antisocial behavior of the adolescents as compared to WLC and POGI, respectively. A multimodal intervention approach appears to be more effective in treating antisocial behavior in adolescents than a psychodynamic oriented group intervention.     

Community-Based Interventions to Reduce Low Income, African American Women's Risk of Sexually Transmitted Diseases: A Randomized Controlled Trial of Three Theoretical Models

A community-based sample of disadvantaged African American women (n = 445) was recruited to participate in 1 of 3 theoretically driven experimental interventions based on either the theory of gender and power, social learning theory, or cognitive behavioral theory. Intervention outcomes were compared with a waiting list control condition. From baseline to postintervention, women in the experimental interventions showed differential change on cognitive indices (knowledge and attitudes) and skill acquisition (partner negotiation skills, correct condom application, lubricant selection, and information-provision to social networks) whereas control participants were unchanged. Women in the 3 experimental interventions also completed follow-up assessments for 1 year following the interventions. In all 3 experimental conditions, condom use increased relative to the control group and there were no differences between the experimental interventions. Women who participated in one of the theoretically grounded interventions continued to increase condom use over the following year. Women entering new relationships reported significantly more condom use than did women who remained in ongoing relationships. The findings suggest that intervention models that have proven effective for women who engage in high-risk behavior may be less effective for women in established relationships for whom risk is primarily derived from the extrarelationship behavior of their partners.     

Other- versus self-focus and risky health behavior: the case of HIV/AIDS

We examined the relationships of other-focus and self-focus with risky health behaviors among HIV+ individuals. Participants who were recruited by an AIDS advocacy organization completed anonymous questionnaires that included measures of other-focus (i.e. empathic concern and perspective-taking) and self-focus (i.e. personal distress and exaggerated internal control); direct measures of concern about the consequences of HIV/AIDS for the self, close others, and society; and a measure of willingness to engage in HIV/AIDS risk behaviors. As predicted, other-focus measures were generally associated with less, and self-focus measures with greater, willingness to engage in risky behavior. However, concern about the consequences of HIV/AIDS for close others was similar to self-focus and was associated with greater willingness to engage in risky behavior. These results are consistent with the notion that prevention efforts focusing on the consequences of HIV/AIDS – and perhaps other communicable diseases – might be more effective if they highlighted the consequences of the disease for society.     

Abuse Experiences in a Community Sample of Young Adults: Relations with Psychiatric Disorders, Sexual Risk Behaviors, and Sexually Transmitted Diseases

This study documents significant associations among lifetime abuse experiences, psychiatric diagnoses, and sexual risk behaviors in a multiethnic community sample of young men and women (N = 1803) in South Florida. Self-report data were collected via structured interviews as part of a longitudinal follow-up of a larger school-based study. Participants were grouped according to extent of lifetime abuse experiences. Cumulative lifetime abuse experiences were associated with increased risk for a broad range of individual lifetime psychiatric disorders, as well as cumulative lifetime psychiatric disorders. Both cumulative abuse experiences and cumulative psychiatric disorders were independently associated with (a) higher levels of sexual risk behaviors and (b) higher risk for lifetime sexually transmitted diseases (STDs). Implications for selective prevention of sexual risk behaviors and STDs among young adults with histories of abuse and psychiatric disorders are discussed.     

Using the Theory of Gender and Power to Examine Experiences of Partner Violence,Sexual Negotiation,and Risk of HIV/AIDS Among Economically Disadvantaged Women in Southern India

This article uses the Theory of Gender and Power to examine women's vulnerability to HIV/AIDS in order to: understand the vulnerability of female sex workers/poor women due to poverty and lack of educational resources; explore women's vulnerability in the context of client/partner violence, alcohol use, male partner's high-risk behaviors, and women's lack of control in their intimate relationships; and explore the role of traditional heterosexual gender norms in the outcomes of sexual negotiation. Ethnographic data were collected from 32 women and 38 men in India as part of an ongoing National Institute of Mental Health study. Results highlighted women's vulnerability to HIV/AIDS stemming from partner violence, alcohol use, poverty, dangers of sex work environments, and tacit acceptance of cultural/gender norms.     

The Risk and Protective Functions of Perceived Family and Peer Microsystems Among Urban Adolescents in Poverty

Utilized a pattern-based approach to discover the different constellations of perceived social transactions separately for family and peer systems and explored the risk and protective functions of these microsystem profiles for both depression and antisocial behavior among a sample of ethnically and racially diverse urban adolescents living in poverty. Measures of perceived social support, involvement and hassles with family and peers, as well as perceived social acceptance and peers' values were entered into two sets of iterative cluster analyses to identify distinct profiles of family and peer transactions. From each of the perceived family and peer transactional analyses, six replicated profiles emerged. Several of the profiles were consistent with expectations from prior literature such as Enmeshing families and Rejecting peer networks, while others were novel and intriguing such as Entangling peers. Family profiles were consistent in their risk and protective associations for both depression and antisocial behavior, while the peer profiles varied in their effects for each developmental outcome. For example, the Rejecting peer profile placed adolescents at increased risk for depression but protected them from antisocial behavior. Implications for future research and preventive intervention are discussed.     

The long-term outcome of a personal network-oriented HIV prevention intervention for injection drug users: The SAFE study

Social influence processes have been found to affect numerous drug and health-related behaviors. We postulated that by using a network-oriented intervention it may be possible to capitalize on social influence processes to reduce human immunodeficiency virus (HIV) risk behaviors. The present study used an experimental study design for delivering a psychoeducational acquired immunodeficiency syndrome (AIDS) preventive intervention to injection drug sharing networks. Participants were recruited from the ALIVE study, an epidemiological study in Baltimore. In the present paper we examine the self-reported behavioral outcomes of 117 injection drug users 18 months after the baseline interview. HIV seronegative experimental participants reported significantly less frequent needle sharing and less injecting of heroin and cocaine than controls. In multiple logistic regression models of HIV seronegative participants, there was a significant negative association between assignment to the experimental group and the HIV-related behaviors of needle sharing and sharing of cookers in the prior 6 months; controls were 2.8 times more likely than experimentals to report needle sharing and were 2.7 times more likely to report sharing cookers. The results of this 18-month follow-up suggest that among injection drug users network-oriented interventions may be a promising approach to HIV prevention.     

Effect of dispenser location on taking free condoms in an outpatient cocaine abuse treatment clinic

Crack cocaine use increases risky sexual behavior and HIV exposure; therefore, safe sexual practices should be encouraged during cocaine addiction treatment. Research indicates that placing condom dispensers in private restrooms increases taking free condoms. We investigated two other dispenser locations (a day room vs. counselors' offices) and found that substantially more condoms were taken when dispensers were in the day room. This is an important issue for public health facilities without private restrooms.     

Keeping the Spirit of Community Partnerships Alive in the Scale Up of HIV/AIDS Prevention: Critical Reflections on the Roll Out of DEBI (Diffusion of Effective Behavioral Interventions)

DEBI, or the Diffusion of Effective Behavioral Interventions is the largest centralized effort to diffuse evidence-based prevention science to fight HIV/AIDS in the United States. DEBI seeks to ensure that the most effective science-based prevention interventions are widely implemented across the country in community-based organizations. Thus, this is a particularly timely juncture in which to critically reflect on the extent to which known principles of community collaboration have guided key processes associated with the DEBI rollout. We review the available evidence on how the dissemination of packaged interventions is necessary but not sufficient for ensuring the success of technology transfer. We consider additional principles that are vital for successful technology transfer, which were not central considerations in the rollout of the DEBI initiative. These issues are: (1) community perceptions of a top-down mode of dissemination; (2) the extent to which local innovations are being embraced, bolstered, or eliminated; and (3) contextual and methodological considerations that shape community preparedness. Consideration of these additional factors is necessary in order to effectively document, manage, and advance the science of dissemination and technology transfer in centralized prevention efforts within and outside of HIV/AIDS.     

西方消费者研究概述

消费者研究是近年来西方心理学应用研究中一个非常活跃的领域。在近 40年的发展中 ,消费者研究的范围不断扩大 ,数量不断增多 ,质量也不断提高。本文考察了西方消费者研究的发展趋势 ,对比了主要的消费者研究阵营 ,并通过对消费者研究中三个亚领域———社会认知、BDT和后现代消费者研究之间的差异和共同之处的探讨 ,强调了各领域之间有很大的合作空间。     

On the meaning of meaning when being mean: commentary on Berkowitz's "on the consideration of automatic as well as controlled psychological processes in aggression"

Berkowitz (this issue) makes a cogent case for his cognitive neo-associationist (CNA) model that some aggressive behaviors occur automatically, emotionally, and through conditioned association with other stimuli. He also proposes that they can occur without "processing," that is, without meaning. He contrasts his position with that of social information processing (SIP) models, which he casts as positing only controlled processing mechanisms for aggressive behavior. However, both CNA and SIP models posit automatic as well as controlled processes in aggressive behavior. Most aggressive behaviors occur through automatic processes, which are nonetheless rule governed. SIP models differ from the CNA model in asserting the essential role of meaning (often through nonconscious, automatic, and emotional processes) in mediating the link between a stimulus and an angry aggressive behavioral response.     

早期累积家庭风险对青少年内化问题的影响：弹性双重机制

为了解早期累积家庭风险因素对青少年内化问题的影响及其心理机制,采用累积家庭风险问卷、个人成长主动性问卷、领悟社会支持问卷以及青少年内化问题问卷对780名青少年进行调查。结果表明：（1）累积家庭风险对青少年内化问题具有显著的正向预测作用;（2）累积家庭风险因素还通过个人成长主动性和领悟社会支持的中介作用影响青少年内化问题。研究结果有助于揭示累积家庭风险对青少年内化问题的影响机制,对预防以及减少青少年内化问题行为具有一定的启示作用。     

Examining the relationship between use of sexually explicit media and sexual risk behavior in a sample of men who have sex with men in Norway

The purpose of this study was to investigate consumption patterns of gay‐oriented sexually explicit media (SEM) among men who have sex with men (MSM) in Norway, with a particular emphasis on a possible relationship between gay SEM consumption and HIV risk behavior. Participants included 529 MSM living in Norway recruited online to complete a SEM consumption and sexual risk survey. Of the 507 participants who responded to the all items measuring exposure to SEM, 19% reported unprotected anal intercourse with a casual partner (UAI) in last 90 days, and 14% reported having had sero‐discordant UAI. Among those with UAI experience, 23% reported receptive anal intercourse (R‐UAI) and 37% reported insertive anal intercourse (I‐UAI). SEM consumption was found to be significantly associated with sexual risk behaviors. Participants with increased consumption of bareback SEM reported higher odds of UAI and I‐UAI after adjusting for other factors using multivariable statistics. MSM who started using SEM at a later age reported lower odds of UAI and I‐UAI than MSM who started earlier. Future research should aim at understanding how MSM develop and maintain SEM preferences and the relationship between developmental and maintenance factors and HIV sexual risk behavior.