Preventing HIV infection in heterosexual women: What do we know? What must we learn?

Women are becoming infected with HIV via heterosexual activity at an accelerating rate, both in the United States and globally. Although a number of evaluations of behavioral risk-reduction interventions for women have been reported, many suffer from methodological problems that weaken confidence in their findings, and furthermore it is clear that many women are unable to respond to the interventions that have been tested. Most women infected through heterosexual activity are infected by their primary partner, yet achieving consistent condom use with this partner can be highly challenging for women. The present article presents recent work and innovative ideas for intervention strategies that may be more feasible, and thus more effective, for women at risk for HIV infection by their primary male partner.     

An empirical study of the decision to use condoms among Norwegian adolescents using the theory of reasoned action

The decision whether or not to use condoms was studied among Norwegian adolescents using the theory of reasoned action (TRA). The empirical data stem from a survey of a random sample of 3000 adolescents aged 17–19 (response rate 60.9 per cent). A total of 1172 persons had made their sexual debuts, and thus constituted the material of this paper. TRA is an expectancy-value model of attitude for understanding and changing a behaviour, and views condom behaviour as a decision based upon consideration of the expected consequences of using or not using condoms. The decision whether or not to use a condom was primarily under normative control, and immediate consequences were more important than long-term consequences, indicating that persuasive communications should pay more attention to social pressure and psychological costs. Most of the effect of prior behaviour upon intention was not mediated by attitudes and subjective norm, and by far exceeded the effects of attitudes and subjective norm, raising doubts of the generality of the model. The possible inclusion of a measure of perceived behavioural control is discussed.     

Attitudes toward condoms as AIDS prophylaxis in homosexual men: Dimensions and measurement

Abstract

Increases in condom use among homosexually active men are crucial to containing the spread of AIDS. The present study examined the components of attitudes and beliefs toward condom use in homosexual and bisexual men using a modified version of Brown's Attitude toward condoms scale. Factor analysis revealed five clear dimensions: viewing condoms as unreliable and unerotic; as protection from infection; as unavailable when needed; as interrupting sex; and viewing condoms as a responsibility and being comfortable with condom use. Five subscales constructed from these dimensions differentiated significantly between homosexual men who used condoms frequently and infrequently or never. Four of the subscales (excepting the Protection from Infection subscale) differentiated frequency of oral condom use; only the Responsibility and Comfort with Condom Use subscale differentiated frequency of anal condom use. The Homosexual Attitudes toward Condom Use scale demonstrates that (1) dimensions of beliefs and attitudes toward condom use in homosexually active men differ substantially from those in heterosexual individuals; (2) a reliable and valid scale for measuring such attitudes now exists; (3) factors influencing condom use in this population differ for oral and anal intercourse; (4) this scale enables further research on determinants of condom use, and effects of modifying attitudes toward condom use, in homosexually active men to be carried out.