Stages of change, decisional balance, and self-efficacy in condom use among rural African-American stimulant users.

This pilot study (a) examined the stages of change (SOC) for condom use with primary and casual partners among rural heterosexual African American stimulant users, (b) identified gender differences in variables associated with SOC, and (c) assessed the association of SOC with decisional balance and self-efficacy. A total of 72 participants completed the study. SOC with a primary partner were much lower than with a casual partner, indicating more consistent condom use with casual partners. Significant gender differences existed in decisional balance for condom use for both primary (p = .02) and casual partners (p =.03), with women having higher decisional balance scores than men. Women also reported higher self-efficacy scores for condom use with casual partners than men. In regression models, age, decisional balance, and self-efficacy were significantly associated with SOC for condom use with a primary partner; however, only self-efficacy was significantly associated with SOC with casual partners. The results provide support for the development of interventions that promote the advantages of and increase self-efficacy for condom use.

Factors associated with sexually transmitted infections in men and women.

BACKGROUND: Sexually transmitted infections (STIs) remains a serious healthcare problem costing approximately 13 billion dollars annually to treat. Men and women who contract STIs have a higher risk for reinfection and for developing human immunodeficiency virus (HIV). Determining the risk factors associated with STIs in a community would be helpful in designing culturally appropriate tailored interventions to reduce spread of STIs. PURPOSE: The purpose of this retrospective chart review was to determine the frequency and type of STIs, as well as to determine the predictor variables associated with STIs among those seeking treatment at a local inner city health unit. METHOD: A total of 237 medical records were reviewed from a STI clinic. The sample comprised 119 men and 118 women, of whom 70.9% were African American. The mean age was 27, and 38% had a prior STI. Men used significantly more condoms (chi(2) = 24.28, p = 0.000), had more sexual partners (chi(2) = 18.36, p = 0.003), and had more prior infections of gonorrhea (chi(2) = 10.04, p =0.002) than women. Women had significantly more prior infections of Chlamydia (chi(2) = 11.74, p = 0.001). Using no type of birth control measures (pills, diaphragm, implants) was a significant predictor of number of sexual partners (t = 2.441, p < 0.015), but negatively associated with condom use (t = -12.290, p < 0.000). CONCLUSIONS: Over one-third had a prior STI, indicating that individuals do not perceive themselves to be at risk for another STI, and choose not to use condoms. Reasons why individuals continue to put themselves at risk need to be explored in gender specific focus groups so that tailored sexual risk reduction programs can be designed to meet the needs of different communities.

Sensation seeking, self-esteem, and unprotected sex in college students.

This descriptive correlational study examined the relationships of sexual sensation seeking, self-esteem, and self-efficacy in condom use, stages of change, and alcohol consumption to HIV risk-taking behaviors among college students. A total of 159 students completed an online survey in 2004. Instruments included the Sexual Sensation Seeking Scale, College Alcohol Problems Scale, Condom Use Scale, and Rosenberg Self-Esteem Scale. High sensation seekers had higher self-esteem, more self-efficacy in condom usage, fewer problems associated with alcohol consumption, and belonged to Greek organizations (F [1,158] = 12.54; p < .0005). Women who were high sensation seekers perceived more advantages (F [1, 116] = 1.67; p = .05) than disadvantages (F [1, 116] = 2.01; p = .01) to using condoms. Men consumed significantly more alcohol and had more social problems related to alcohol use than women (F [1, 158] = 5.04; p < .03). Students in Greek organizations had significantly more positive attitudes (X(2) [1] = 4.55; p < .03) and more respect for themselves (X(2) [1] = 11.22; p < .0008) than other students and were more likely to be tested for HIV (X(2) [1] = 3.85; p < .05). Students with low self-esteem consumed more alcohol, had more sexual partners, and had more HIV risk-taking behaviors than other students. Even though students were reported to be efficacious in condom usage, they used them inconsistently with their sexual partners and were in the earlier stages of change. Interventions are needed in the community to help sexually active individuals take responsibility for their sexual health and to increase the awareness of the need to be tested for HIV.

Sexual sensation seeking, compulsivity, and HIV risk behaviors in college students.

The purpose of this descriptive and correlational study was to understand the role of sexual compulsivity, sensation seeking, and alcohol use as mediators of HIV risk behaviors among college students. College students (n = 256) completed an online survey in 2003. Instruments included the Sexual Compulsivity Scale (SCS), Sexual Sensation Seeking Scale (SSS), and the College Alcohol Problem Scale (CAPS). Men scored higher on the SSS and SCS than women. Women who belong to Greek organizations reported significantly more personal problems, including depression and low self-esteem, after consuming alcohol than women who were not members of Greek organizations. Four predictor variables associated with HIV risk behaviors were age, high score on SSS and CAPS, but a low score on SCS. The personality dispositions of sexual sensation seeking and compulsivity among college students may need to be explored in other college settings, to determine if these traits are related to HIV risk taking behaviors. Interventions to help women better cope with the effects of alcohol and self-esteem issues may be beneficial.

Stages of change and condom use among an Internet sample of gay and bisexual men.

The purpose of this descriptive correlational study using the transtheoretical model was to determine the relationship between stages of change and condom use among gay and bisexual men with primary (steady) and casual (occasional) partners. A convenience sample of 241 gay and bisexual men was recruited from the Internet. The majority of men (n = 198, 82%) never used condoms during anal, vaginal, or oral intercourse with primary partners, indicating they were in the first of five stages of change (precontemplation). Thirty percent (n = 71) of men reported using condoms every time during anal intercourse with casual partners and were in the last stage of change (maintenance). Multiple regression analysis revealed that older bisexual men who informed partners of their HIV status and who were confident and perceived more advantages in using condoms were in higher stages of change. By placing participants into various stages of change, stage specific interventions can be designed.

Pros and cons of condom use among gay and bisexual men as explored via the Internet.

The purpose of this study was to conduct a survey utilizing Internet technology related to gay and bisexual men's condom use behavior as an expression of safer sexual practices. A total of 241 self-identified gay and bisexual men responded to the questionnaire in a 3-month period of time. Confidentiality was assured by utilizing an electronic system whereby the respondents e-mail address was eliminated. The study was conceptually guided by the use of the Transtheoretical Model of Behavioral Change (TMC) and the pros and cons of condom of use were explored. Fifty-six percent of the participants reported that one advantage (pro) of using condoms with casual partners was that it would make them safer from disease. About half of the respondents (n = 119, 49%) reported a history of one or more sexually transmitted diseases. There were 14 variables found to be significantly associated with using a condom with primary and casual partners among gay and bisexual men. Essentially, findings from this study corresponded to results obtained by more traditional data collection methods. Therefore, the authors conclude that electronic data collection may well be an alternative means for collecting sensitive data such as those collected in this study.