RESUMEN

This randomized clinical trial evaluated an HIV-risk reduction (HIV-RR) intervention based on the information-motivation-behavioral skills model. At baseline, 102 women (M age = 29 years; 88% African American) completed a survey regarding HIV-related knowledge, risk perceptions, behavioral intentions, and risk behavior. Participants were then assigned to either the HIV-RR intervention or a health-promotion control group. Postintervention and follow-up data indicated that women in the HIV-RR program enhanced their knowledge and strengthened their risk reduction intentions relative to controls. Moreover, HIV-RR women who expressed "imperfect" intentions also increased their condom use, talked more with partners about condom use and HIV testing, and were more likely to have refused unprotected sex.

Asunto(s)

RESUMEN

Our objective was to determine the priorities of low-income women regarding health, relationship, and social concerns. Street-intercept surveys were conducted with 161 low-income urban women (mean = 27 years, 85% African American, 80% single mothers) regarding their perceptions of the threat associated with 48 health and social problems. Women rated acquired immune deficiency syndrome (AIDS) as their most important health, social, or relationship concern. Nearly one half of all women indicated that they would attend risk reduction programs to learn how to avoid infection with human immunodeficiency virus (HIV). AIDS is perceived as a serious threat to women's health, and interventions to reduce risk are welcomed.

Asunto(s)

RESUMEN

Self-efficacy theory has had considerable influence in studies of health-related behaviors, including the prevention of sexual transmission of HIV. However, imprecise operationalization of self-efficacy theory in HIV prevention research is common and has important implications for the prediction of risk-reducing behavior from self-efficacy beliefs. In many instances, constructs other than self-efficacy have been assessed. In this article, the operationalization and measurement of self-efficacy in the context of HIV-risk-reduction research are reviewed and challenges inherent to such efforts are identified. Recommendations for enhancing the prediction of risk-reducing behavior from self-efficacy beliefs are also provided.

Asunto(s)

RESUMEN

The trustworthiness of self-reported sexual behavior data has been questioned since Kinsey's pioneering surveys of sexuality in the United States (Kinsey et al., 1948, 1953). In the era of HIV and AIDS, researchers and practitioners have employed a diversity of assessment techniques but they have not escaped the fundamental problem of measurement error. We review the empirical literature produced since Catania et al.'s (1990) review regarding reliability and validity of self-administered and automated questionnaires, face-to-face interviews, telephone interviews, and self-monitoring approaches. We also provide specific recommendations for improving sexual behavior assessment. It is imperative that standardized self-report instruments be developed and used for sexual risk-behavior assessment.

Asunto(s)

RESUMEN

This research evaluated a motivation-based HIV risk reduction intervention for economically disadvantaged urban women. Participants completed a survey that assessed HIV-related knowledge, risk perceptions, behavioral intentions, sexual communication, substance use, and risk behavior. A total of 102 at-risk women (76% African American) were randomly assigned to either the risk reduction intervention or to a waiting list. Women were reassessed at 3 and 12 weeks. Results indicated that treated women increased their knowledge and risk awareness, strengthened their intentions to adopt safer sexual practices, communicated their intentions with partners, reduced substance use proximal to sexual activities, and engaged in fewer acts of unprotected vaginal intercourse. These effects were observed immediately, and most were maintained at follow-up.

Asunto(s)

RESUMEN

Assessment of behavioral skills remains critical to the evaluation of HIV prevention interventions; however, investigators often rely upon participant reports of self-efficacy to estimate such skills. We evaluated the relationship between self-efficacy beliefs for condom use and behavioral performance. Forty-three men completed the Condom Use Self-Efficacy Scale (CUSES) and participated in 2 behavioral assessments. Regression analyses indicated that the CUSES subscales relevant to negotiation of condom use did not account for a significant amount of variability in interpersonal skills; similarly, the CUSES subscale relevant to technical condom use skill did not account for variability in the condom application scores. We caution investigators against the assumption that higher self-efficacy reflects behavioral competence for HIV-risk reduction.

PIP: It has been estimated that 1% of young men in the US are infected with HIV. Concern about AIDS has led to the development of theoretical models which address the determinants of behavior change. According to Bandura's self-efficacy theory, self-efficacy informs decisions to engage in risk-reducing behaviors, determines the amount of effort expended, and influences the extent to which an individual perseveres when obstacles are encountered. The Condom Use Self-Efficacy Scale (CUSES) assesses efficacy to purchase condoms, apply and remove them, and negotiate their use with partners. Evidence exists for the reliability of the CUSES. The authors investigated whether perceptions of condom use efficacy measured by the CUSES correlate with related skills when assessed by behavioral role-plays. 43 men completed the CUSES and participated in two behavioral assessments. Regression analyses indicated that the CUSES subscales relevant to the negotiation of condom use did not account for a significant amount of variability in interpersonal skills. Moreover, the CUSES subscale relevant to technical condom use skill did not account for variability in condom application scores. Caution is recommended before assuming that higher self-efficacy reflects behavioral competence for HIV risk reduction.

Asunto(s)