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PubMed1999

Demographic and attitudinal variables related to high-risk behaviors in Asian males who have sex with other men.

Although AIDS is spreading rapidly in minority communities, little is known about attitudes, knowledge, and behavior related to AIDS and HIV in the Asian community. The purpose of this study was to examine these variables in a sample of gay Asian males, as well as to investigate the relationship between knowledge, sources of information, culturally influenced attitudes and high-risk behaviors in this population. Results from a sample of 60 young Asian men who self-identified as "having sex with other men" indicated they were generally knowledgeable about methods of transmission and prevention, and appeared linked to a large information network that included informal sources such as peers and formal sources. However, significant percentages held culturally biased views of AIDS, such as believing race of partner or one's own gender role in the sexual encounter determined level of risk; and one third of the sample did not use condoms regularly. Having been tested for HIV was associated with holding less traditional cultural beliefs and a higher sexual activity level. Open communication about safer sexual practices was associated with monogamous as opposed to multiple relationships and with decreased tendency to engage in alcohol-related unprotected sex. Variance in overall risk was predicted by demographic variables such as education, age, and level of sexual activity, rather than by the attitudinal factors measured. Limitations of this exploratory study include a time-limited subject recruitment period and consequent small sample size, a homogeneous sample weighted toward young, well-educated, and middle-class respondents, and the exclusion of non-English speaking individuals. Nevertheless, study findings suggest that educational outreach targeting Asians who have sex with other men needs to address inaccurate cultural beliefs about HIV/AIDS, emphasize consistent condom use, and encourage models of open communication with partners about safer sexual practices.

Adolescent↗
PubMed1995

Demographic and sociocultural factors influencing contraceptive use in Uganda.

Bivariate and multivariate analyses of the influence of demographic and sociocultural factors on contraceptive knowledge, attitudes and practice among currently married respondents in Uganda show that: (1) contraceptive knowledge is widespread, even among women with no education; (ii) the majority of the respondents have favourable attitudes towards contraceptive use; (iii) the level of contraceptive use is low in comparison with knowledge and attitudes. Post-primary education, ethnicity, residence, the presence of the spouse in the household and discussion of family planning with spouse were strong predictors of knowledge and favourable attitudes towards contraception. Secondary or higher education, discussion of family planning with spouse and urban residence strongly influenced contraceptive use, but child mortality did not. The use of condoms as a behavioural change to avoid contracting HIV/AIDS was low. The results suggest that, particularly in rural areas, family planning services are not meeting the needs of potential clients.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Factors associated with married women's selection of tubal sterilization and vasectomy.

Multivariate analyses of data from 248 married women scheduled for tubal sterilization and 165 wives of men scheduled for vasectomy indicated that male and female sterilization methods were selected for different reasons and under different circumstances. More specifically, the woman who underwent tubal sterilization was more likely to have perceived that she had greater influence than her husband over the sterilization decision, to have had cesarean section or vaginal delivery in association with sterilization, to have chosen tubal ligation because her spouse refused to undergo the alternative procedure or because it was convenient to combine it with delivery or other surgery, and to have had a spouse who was unwilling to be sterilized because of possible side effects associated with vasectomy. The woman whose husband underwent vasectomy was more likely to have been very fearful of surgery in general or especially fearful of reproductive surgery, to have known many men who already had had a vasectomy, to have perceived that her husband was more strongly motivated than herself to terminate childbearing, to have had a spouse who participated in birth control, and to have chosen vasectomy because it was easier or less expensive or because her physician advised against tubal sterilization.

Adult↗
PubMed1994

Dimensions of self-efficacy among three distinct groups of condom users.

Condom use self-efficacy can be defined as expectations about one's ability to use condoms under a variety of circumstances. This investigation examined the factor structure of the Condom Use Self-Efficacy Scale (CUSES) in an 18- to 23-year-old college population (N = 339) and tested the ability of the factors to distinguish among three groups of condom users (nonusers, sporadic users, and ritualistic users). Emerging from a principal components analysis were four reliable factors labeled Mechanics, Partner's Disapproval, Assertive, and Intoxicants. Results from a discriminant analysis indicated that sporadic users were best distinguished from ritualistic users by number of sex partners, use of intoxicants, and intensity of alcohol use. The sporadic users had more sex partners, were less confident of their ability to use condoms when intoxicated, and were heavier drinkers than were the ritualistic users. Nonusers were best distinguished from ritualistic users by the factor labeled Assertive. Nonusers were significantly less confident in their ability to discuss condoms and to insist on their use with a sexual partner. Implications of the findings for improving campus-based programs to prevent the spread of human immunodeficiency virus infection and sexually transmitted diseases are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1997

A scale for Assessing Health Care Providers' Teaching and Communication Behavior regarding asthma.

Partnership between health care providers and patients is important for controlling illness. A limited number of studies show how to assess health professionals' communication and partnering behavior. The relationship between these aspects of professional behavior and enhanced management of disease by patients has received little empirical study. The research reported here developed a Health Care Providers' Teaching and Communication Behavior (TCB) scale for assessing the teaching and communication behavior of clinicians treating patients with asthma. Such a tool is needed for research related to provider-patient relationships and for evaluation of professionals' performance.

Adult↗
PubMed2001

Safer sex decision-making among men with haemophilia and HIV and their female partners.

An exploratory qualitative study of adult heterosexual men with haemophilia and HIV and women who were their sexual partners was conducted as formative research to better understand cognitive factors involved in behavioural intentions and practices which comprise HIV risk-reduction for sexual transmission. The study sought to generate hypotheses, uncover themes, and develop a broad perspective on possible determinants of behaviours related to HIV transmission risk reduction. Qualitative analysis of these data served as a basis for developing a subsequent quantitative, hypothesis-testing survey and an intervention. Face-to-face interviews were conducted with 23 single men and 28 married men with haemophilia and HIV infection, and 28 married women partners selected through stratified, purposeful sampling. The interviews identified beliefs, attitudes, and values underlying decisions regarding target behaviours related to preventing sexual transmission of HIV, including (1) using condoms consistently during vaginal intercourse and (2) talking to partners about risk reduction. The interviews elicited information about perceived advantages and disadvantages of performing each of the targeted behaviours, and factors that facilitate or prevent performing them. Qualitative analysis of coded responses yielded important themes regarding how choices are made about sexual activity and safer sex. Most notably, communication between partners (1) plays a direct, key role in facilitating condom use and (2) forms the basis for maintaining emotional intimacy in these relationships. The link between condom use and communicating about safer sex was viewed as pivotal in achieving HIV prevention for individuals in serodiscordant couples. Recommendations for risk reduction intervention development are discussed.

Adult↗
PubMedDate not supplied

A profile of the adolescent male family planning client.

CONTEXT: Family planning programs and policies increasingly focus on the male partner's roles and responsibilities in contraceptive decision-making and use. To effectively tailor services for males, policymakers and providers must refine their understanding of men's psychosocial and reproductive health needs. METHODS: Using self-administered questionnaires, 1,540 sexually active males aged 19 and younger who attended family planning clinics in California provided information about their sexual behavior, contraceptive use, pregnancy and parenting history, and psychosocial characteristics. Logistic regression was used to examine factors that contributed to effective contraceptive use. RESULTS: Although 73% of participants reported having used a birth control method at first intercourse, only 59% said that they or their partner had used an effective method at last intercourse, and 35% had used no method. If the client was uncomfortable with his method, the odds that he had used an effective method at last intercourse were reduced (odds ratio, 0.4). The likelihood of use at last intercourse was increased among males who agreed with their partner about their method and those who had never impregnated a partner (1.4 and 1.9, respectively). CONCLUSIONS: To adequately serve young males, clinics must take into account their sexual and contraceptive histories. But screening should go beyond traditional family planning techniques to discuss how to improve communication with partners and other lifestyle issues that may interfere with consistent use.

Adolescent↗
PubMed2001

Psychological predictors of sexual behaviors related to AIDS transmission.

This study was designed to assess the differential value of several psychological variables with regard to predicting safe-sex behavior. A sample of 94 male and 179 female undergraduate students, ranging in age from 16 to 66 years, were surveyed about sexual issues related to safe-sex practices. The survey included scales measuring participants' knowledge of transmission of AIDS, self-perception of safe-sex communication, fear and concern about AIDS, attitudes toward AIDS victims, and self-report of risky behavior. Several interesting relationships among predictor variables were found. For instance, favorable attitudes toward AIDS victims were positively correlated with knowledge about AIDS transmission, perceived communication with partners about safe sex, and fear of acquiring AIDS. However, only two predictor variables were independently predictive of self-reports of risky sexual behavior; specifically, fear about AIDS transmission was positively correlated with risky behavior, while communication was negatively correlated with risky behavior. These data suggest a need for a model that allows for complex, reciprocal relationships between the cognitive, emotional, and behavioral components of safe-sex practice. Implications are applied to research with college populations.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Safe sex or safe love: competing discourses?

The way in which sex may be constructed as safe through its relationship with 'love' is the concern of this study. Interviews with 112 heterosexual women and men from discos and bars in Melbourne, Australia, catering to single adults revealed the pervasive construction of sex within the discourses of 'love' and 'romance'. The relationship of these discourses to unsafe practices is discussed and the article presents an analysis of the normative function of the sex-as-love/sex-as-desire opposition in terms of safe sex and HIV/AIDS prevention. We conclude that health messages which emphasize that 'sex is unsafe' may be counterproductive. We illustrate how women and some men construct casual sex as a strategy for obtaining the possibility of 'love'. For these women and men, 'safe sex' as 'unprotected sex' is viewed as a strategy for maximizing the possibility that the casual encounter will result in a longer term relationship. On the other hand, 'unsafe sex' as 'unprotected sex' is viewed as a strategy that is more likely to interrupt the construction of romance in the causal encounter thus risking the possibility of love as the desired outcome.

Adult↗
PubMed1997

HIV/AIDS risk in heterosexual college students. A review of a decade of literature.

Empirical studies dealing with the psychosocial correlates of HIV risk among heterosexual college students are reviewed, including findings related to such theoretical variables as HIV/AIDS-related knowledge, personal and partner's attitudes toward condom use, perceived susceptibility, communication with sex partners, and sexual self-efficacy. Although college students are highly knowledgeable about basic HIV/AIDS facts, they retain some misperceptions about disease transmission. They hold neutral-to-negative hedonistic and practical attitudes about using condoms: those who have engaged in risky behavior accurately perceive their greater susceptibility to infection and experience anxiety regarding transmission of HIV infection. Heterosexual college students communicate infrequently with their partners about safer sex, but they often agree to a partner's suggestion that they use condoms. Higher levels of sexual self-efficacy among college students have been associated with a lower risk for HIV transmission. Limitations and clinical implications of the findings and recommendations for future interventions are discussed.

Condoms↗
PubMed1986

Married women's dissatisfaction with tubal sterilization and vasectomy at first-year follow-up: effects of perceived spousal dominance.

Examination of first-year follow-up data obtained from 234 tubal ligation women and 154 vasectomy wives indicated a very low incidence of actual regret in both groups. However, use of a broader measure of satisfaction/dissatisfaction indicated that tubal ligation women had significantly more positive feelings about the sterilization decision than did vasectomy wives. Results of a series of multivariate statistical analyses demonstrated that group differences in satisfaction were related to (1) the disproportionate prevalence of perceived male control (particularly extensive control) over reproductive decisions among vasectomy wives and the negative effect it had upon subjects in both groups and (2) the disproportionate prevalence of female control over reproductive decision-making among tubal ligation women and the positive effect it had among subjects in this group. Study results point to the importance of couple counseling and exercising control over one's own body.

Adult↗
PubMed1998

Attenders at young people's clinics in Southampton: variations in contraceptive use.

This paper presents findings from a survey of 424 people attending nine young people's clinics within the Southampton Community Health NHS Trust. In addition to recording some descriptive background data on the people attending the clinics, one major aim of the study was to investigate whether talking to the sexual partner about contraception before their first intercourse together and delaying this first intercourse influenced contraceptive use. Overall, 40 per cent of people attending the clinics were aged 16 or under, although there was some variation between clinics in the age groups attracted. Most clients were female (88 per cent), had ever had sexual intercourse (92 per cent), reported four or more lifetime partners (42 per cent) but only one partner within the last six months (73 per cent) and were currently in a relationship (75 per cent). Potential for contraception and sexually transmitted infection was widespread; 46 per cent (of non-virgins) had had intercourse without contraception at least 'a few times' and 18 per cent used condoms 'rarely' or 'never'. In terms of first intercourse with current/most recent partner, 17 per cent had not used any contraception and 32 per cent had failed to use condoms. The most important findings from this study were that use of contraception (and condoms in particular) on the occasion of first intercourse with the current or most recent partner was significantly associated with the following; if partners had talked to each other about contraception before having intercourse together for the first time (p<0.001), and also if this first intercourse was delayed beyond four weeks as opposed to over a few days of first 'going-out' together (p<0.001). Suggestions for further in-depth research are made.

Adolescent↗
PubMed2001

HIV negative women's communication of their HIV status to their intimate partners.

This article identifies factors that differentiate HIV-negative, drug-involved women in New York City (N = 104) who communicate their HIV status to their intimate partners from those who do not. Findings indicate that HIV-negative women are more likely to reveal their status to their intimate partners if they (a) were tested more often for HIV, (b) talked with supporters about various HIV/AIDS-related issues besides their HIV status, (c) had a larger number of other supporters (in addition to intimate partners), (d) also communicated their HIV status to a larger percent of their other supporters, and (e) felt very sure they could ask their partner(s) about their partners' other sex partners. Drug treatment programs may be able to help HIV-negative women avoid contracting the virus by encouraging them to communicate with their supporters, especially their intimate partners, about their HIV status as well as HIV risk reduction practices.

Adult↗
PubMed2003

Partner awareness regarding the adult sequelae of childhood sexual abuse for primary and secondary survivors.

This qualitative study investigates factors that may facilitate or impede awareness within couples regarding the sequelae of childhood sexual abuse for adult females and their partner. Six couples were interviewed about perceived effects of the abuse for self and partner and their perceptions regarding their awareness of these effects. Transcribed data were analyzed using grounded-theory methodology. Emergent themes regarding potential barriers to and facilitators of agreement are outlined in the context of the expressive and receptive abilities and motivations of each partner in communicating about the abuse. Preliminary implications for marriage and family therapy and further research are provided.

Adult↗