Using the integrative model of behavioral prediction to understand college students’ STI testing beliefs,intentions, and behaviors

ABSTRACT

Objectives: To identify salient behavioral determinants related to STI testing among college students by testing a model based on the integrative model of behavioral (IMBP) prediction. Participants: 265 undergraduate students from a large university in the Southeastern US. Methods:Formative and survey research to test an IMBP-based model that explores the relationships between determinants and STI testing intention and behavior. Results: of path analyses supported a model in which attitudinal beliefs predicted intention and intention predicted behavior. Normative beliefs and behavioral control beliefs were not significant in the model; however, select individual normative and control beliefs were significantly correlated with intention and behavior. Conclusions: Attitudinal beliefs are the strongest predictor of STI testing intention and behavior. Future efforts to increase STI testing rates should identify and target salient attitudinal beliefs.     

A Report on Student Health Services

Abstract

Objective: Stress impacts college students, faculty, and staff alike. Although meditation has been found to decrease stress, it is an underutilized strategy. This study used the Reasoned Action Approach (RAA) to identify beliefs underlying university constituents’ decision to meditate. Participants: N = 96 students, faculty, and staff at a large midwestern university during spring 2012. Methods: A survey measured the RAA global constructs and elicited the beliefs underlying intention to meditate. Thematic and frequency analyses and multiple regression were performed. Results: Quantitative analyses showed that intention to meditate was significantly predicted (R² = .632) by attitude, perceived norm, and perceived behavioral control. Qualitative analyses revealed advantages (eg, reduced stress; feeling calmer), disadvantages (eg, takes time; will not work), and facilitating circumstances (eg, having more time; having quiet space) of meditating. Conclusions: Results of this theory-based research suggest how college health professionals can encourage meditation practice through individual, interpersonal, and environmental interventions.     

Qualitative research on homosexual and bisexual behavior relevant to HIV/AIDS

The spread of the international AIDS pandemic has drawn attention to the urgent need for data on human sexual behavior; yet the lack of an established tradition of theory and method in sex research has limited the development of research initiatives in this area. This has been particularly true in the study of homosexual and bisexual behavior, which has relied heavily on the use of quantitative survey methods that largely fail to address cross‐cultural differences in the structure and meaning of same‐sex sexual experience. More qualitative approaches offer the possibility of investigating homosexual and bisexual behavior within a broader social and cultural context and can therefore play an important role in developing a framework for the comparative analysis of behavioral data. This article seeks to contribute to the development of theory and method in sex research by outlining key research issues and possible methodologies for the qualitative investigation of homosexual and bisexual behavior in relation to HIV/AIDS.     

The Effects of Discriminate Message Interventions on Behavioral Intentions to Engage in Physical Activities

Objective: The authors attempt to show the usefulness of discriminate messages designed to increase college students' intentions to engage in physical activities. Participants: The authors selected a sample of undergraduate students enrolled in communication courses at a university in the southeastern United States for a baseline online survey (n = 683) and an experiment (n = 99). Methods: The authors selected discriminate beliefs with highest regression weights and sizable effect size with behavioral intention to build messages for classroom intervention. The authors used an analysis of covariance to test the intervention effect of discriminate messages on intention to do physical activities. Results: Students exposed to the discriminate messages were more likely to report positive changes in their self-efficacy and behavioral intentions related to physical activity. Conclusions: Further research on communication theories is required to help design the selected beliefs so that they will be comprehended and ultimately lead to behavioral changes.     

Beliefs underlying stress reduction and depression help-seeking among college students: An elicitation study

Objective: This study illustrates how a theory-based approach can identify college students’ beliefs about stress reduction activities and help-seeking for depression. These beliefs are the basis for intervention design. Participants: A sample of 53 undergraduate students at a public university in the Midwest participated in this research during March 2016. Methods: An open-ended belief elicitation survey was administered online. Beliefs were identified through qualitative thematic analyses. Results: Exercise was students’ most preferred stress reduction activity. Beliefs about exercise emphasized physical benefits yet also not having time for exercise. Beliefs about help-seeking for depression emphasized treatment efficacy, support from others, stigma, and time constraints. Conclusions: Whereas beliefs about positive outcomes inform educational and motivational messages, beliefs about time constraints underscore the need to also consider structural factors that can help students find time to attend to their well-being.     

Social Monogamy in Nonhuman Primates: Phylogeny,Phenotype, and Physiology

Monogamy as a social system has been both a scientific puzzle and a sociocultural issue for decades. In this review, we examine social monogamy from a comparative perspective with a focus on primates, our closest genetic relatives. We break down monogamy into component elements, including pair-bonding and partner preference, mate guarding or jealousy, social attachment, and biparental care. Our survey of primates shows that not all features are present in species classified as socially monogamous, in the same way that human monogamous relationships may not include all elements—a perspective we refer to as “monogamy à la carte.” Our review includes a survey of the neurobiological correlates of social monogamy in primates, exploring unique or common pathways for the elemental components of monogamy. This compilation reveals that the components of monogamy are modulated by a suite of androgenic steroids, glucocorticoid hormones, the nonapeptide hormones oxytocin and vasopressin, and other neurotransmitter systems (e.g., dopamine and opioids). We propose that efforts to understand the biological underpinnings of complex human and animal sociosexual relationships will be well served by exploring individual phenotypic traits, as opposed to pursuing these questions with the assumption that monogamy is a unitary trait or a species-specific characteristic.     

One love: explicit monogamy agreements among heterosexual young adult couples at increased risk of sexually transmitted infections

HIV prevention strategies among couples include condom use, mutual monogamy, and HIV testing. Research suggests that condom use is more likely with new or casual partners, and tends to decline as relationships become steady over time. Little is known, however, about explicit mutual monogamy agreements and HIV testing within heterosexual couples. This study used data from 434 young heterosexual couples at increased risk of HIV and sexually transmitted infections (STIs) to assess (a) couple concordance on perceptions of a monogamy agreement, sustained monogamy, and HIV testing; and (b) the associations of relationship and demographic factors with monogamy agreement, sustained monogamy, and HIV testing. Results indicated only slight to fair agreement within couples on measures of monogamy agreement and sustained monogamy. Overall, 227 couples (52%) concurred that they had an explicit agreement to be monogamous; of those, 162 (71%) had sustained the agreement. Couples with greater health protective communication and commitment were more likely to have a monogamy agreement. Couples of Latino and Hispanic ethnicity and those with children were less likely to have a monogamy agreement. Only commitment was related to sustained monogamy. Having children, greater health protective communication, and perceived vulnerability to HIV and STIs were associated with HIV testing within the couple.     

Indoor Tanning and Problem Behavior

Objective: The authors examined factors predicting college students' use of tanning beds. Participants and Methods: Undergraduate students (N = 745) at a large Northeastern university participated in the study by answering a survey measuring tanning behavior and other psychosocial variables, including sensation seeking, self-esteem, tanning image beliefs, and friends' tanning bed use. Results: All 3 systems from problem behavior theory predicted past tanning bed use and intention to use tanning beds. The authors observed a positive association between sensation seeking and intention to use tanning beds. Tanning image beliefs were positively associated with both past tanning behavior and intention to use tanning beds. Conclusions: Interventions focusing on friend and acquaintance social network influences may be more effective than health-risk campaigns in reducing tanning bed use.     

Prevalence and risk and protective factors associated with HIV-related behavior among transgender people in Hong Kong

Abstract

This paper presents findings from the first large-scale quantitative study into HIV-related behavior among transgender people in Hong Kong. A survey of 195 transgender people found that only one-third of those who had engaged in sexual behavior in the past 3?months reported consistent condom use. Stable relationships, beliefs in low HIV transmission risk, and condom inaccessibility were cited as reasons for inconsistent condom use. The HIV testing figures were also strikingly low. This study demonstrates an urgent need for addressing HIV issues among transgender people in Hong Kong as there are currently no such specific services.     

Relative Efficacy of a Pregnancy,Sexually Transmitted Infection,or Human Immunodeficiency Virus Prevention–Focused Intervention on Changing Sexual Risk Behavior Among Young Adults

Abstract

Objectives: Despite findings suggesting that young adults are more concerned about experiencing an unplanned pregnancy or contracting a sexually transmitted infection (STI) than becoming human immunodeficiency virus (HIV) infected, no empirical work has investigated whether the specific focus of an intervention may be more or less efficacious at changing sexual behavior. Participants: Participants were 198 college students randomized to 1 of 4 conditions: pregnancy intervention, STI intervention, HIV intervention, or a control condition during 2008–2009. Methods: The authors compared the efficacy of 3 theory-based, sexual risk–reduction interventions that were exactly the same except for an exclusive focus on preventing pregnancy, STI, or HIV. Condom use and risky sexual behavior were assessed at baseline and 4-week and 8-week follow-up. Results: Participants exposed to the pregnancy or STI interventions reported greater condom use and less risky sexual behavior than those exposed to the HIV intervention. Conclusions: The focus of sexual risk–reduction interventions may lead to differential behavior change among young adults.     

Using the Theory of Planned Behavior to predict HPV vaccination intentions of college men

Objective: The purpose of this study was to test Theory of Planned Behavior (TPB) constructs in predicting human papillomavirus (HPV) vaccination behavioral intentions of vaccine-eligible college men. Participants: Participants were unvaccinated college men aged 18–26 years attending a large public university in the southeastern United States during Spring 2015. Methods: A nonexperimental, cross-sectional study design was employed. Instrumentation comprised a qualitative elicitation study, expert panel review, pilot test, test-retest, and internal consistency, construct validity, and predictive validity assessments using data collected from an online self-report questionnaire. Results: The sample consisted of 256 college men, and the final structural model exhibited acceptable fit of the data. Attitude toward the behavior (β = .169) and subjective norm (β = 0.667) were significant predictors of behavioral intention, accounting for 58% of its variance. Conclusions: Practitioners may utilize this instrument for the development and evaluation of TPB-based interventions to increase HPV vaccination intentions of undergraduate college men.     

HIV and the Cycle of Trauma in Gay Men

Summary

Forged within the sociocultural context of the collective trauma of AIDS, HIV prevention efforts became rigid, focusing almost exclusively on patient education as risk reduction. However, while some people have not been able to incorporate risk reduction into their behavioral patterns, others have indeed returned to high-risk behavior after a period of reduced risk as evidenced by the “Bareback” movement. HIV prevention education has overlooked the effect of oppression and sexual trauma on the lives of gay men, and the impact of these phenomena on the gay male's interest in, and ability to, negotiate safer sex. Sexual trauma has been shown to have a direct effect on HIV risk and seropositivity. Additionally, as sexual trauma (often in the form of homophobia) and HIV infection have numerous parallels, the gay man may have analogous ways of relating to, processing and dealing with the two phenomena. Case histories are offered to illustrate how the relationship between HIV and sexual trauma may be examined in an effort to enhance the self-esteem and self-concept of the gay man, and thereby offer greater possibilities for him to protect himself.     

MSM's Versus Health Care Providers’ Perceptions of Barriers to Uptake of HIV/AIDS-Related Interventions: Systematic Review and Meta-Synthesis of Qualitative and Quantitative Evidence

ABSTRACT

To compare the perceptions of men who have sex with men (MSM) and health care providers (HCPs) on barriers to uptake of HIV/AIDS-related interventions using existing quantitative and qualitative data. Systematic review and meta-synthesis was employed to combine data from both groups. Based on studies focusing on MSM and HCPs, knowledge about the intervention and intervention's cost emerged as major barriers to uptake whereas HIV- or homosexuality-related stigma/discrimination was a barrier in studies focusing on MSM alone. Lack of practice guidelines was barrier among HCPs only. Few studies exist that focus on perceptions of barriers by HCPs.     

Factors Associated with HIV Sexual Risk Behavior in Male Couples of Mixed HIV Status

Abstract

There are concerns that rates of unprotected anal intercourse and new HIV infections among some gay men have remained at or returned to dangerous levels, similar to those seen in the first decade of the epidemic. Most research on sexual risk behavior of gay men has focused on individuals even though several studies have indicated that unprotected anal intercourse (the most risky of sexual behaviors) is most likely to occur between two men who are regular partners.

This study was conducted with 75 HIV serodiscordant (“mixed HIV status”) male couples. The goals were to assess the types and prevalence of sexual risk behaviors within these dyads, to identify reasons given for engaging in risk behavior with their partner of opposite HIV status, and to examine the association, if any, between risk behaviors and potential individual and partner related factors and context. Both members of the couple were included in all assessments.

There was a tendency for unprotected anal sex to occur more often among younger men, newer couples, Latino men, and men with less education. Lower risk perception and self-efficacy for condom use, desire for sexual spontaneity, intimacy, and personal and partner satisfaction were all related to sexual risk behavior. The men in these relationships also used specific “harm reduction” strategies, based on their own understanding of transmission risk. Therefore it is important to integrate biological and behavioral knowledge to develop effective prevention campaigns. And prevention programs need to consider the ongoing emotional needs of both the HIV seronegative (HIV-) and HIV sero-positive (HIV+) partner.     

Intentions and ethical behavior in trust games

This paper explores if knowledge of one's partner's intention affects cooperative behavior. Results of a trust game experiment show that Player 1's elicited intentions are consistent over an imperfect information treatment, when Player 2 is not aware of her partner's intention, and a perfect information treatment, when she knows it. Evidence highlights that people's intentions on one side of the games shape their beliefs as to how their partner wants them to act when the roles are reversed. Moreover, in the perfect information treatment, participants act in a manner consistent with their own intentions, suggesting that ethical considerations permeate behavior.     

“Knowing Your Status and Knowing Your Partner’s Status Is Really Where It Starts”: A Qualitative Exploration of the Process by Which a Sexual Partner’s HIV Status Can Influence Sexual Decision Making

Gay and bisexual men are at disproportionate risk for human immunodeficiency virus (HIV) infection. While prevention efforts often emphasize consistent condom use, there is growing evidence that men are using seroadaptive safer-sex strategies, such as serosorting and seropositioning. This qualitative analysis of 204 HIV-negative and HIV-positive gay and bisexual men explored the ways that a sexual partner’s HIV status can influence safer-sex strategies and sexual decisions. The majority of the respondents reported that they were influenced by their partners’ HIV status. Those respondents who reported no influence discussed adhering to safer-sex rules that were not dependent on partner status and a lack of concern about HIV. Conversely, respondents who reported influence identified three primary areas of influence: psychological impacts, partner preference and selection, and specific behavioral intentions and strategies. A conceptual model explicating a potential process by which respondents use partner serostatus information in shaping sexual decisions is presented.     

Understanding Physical Activity Behavior in African American and Caucasian College Students: An Application of the Theory of Planned Behavior

Only 30% of college students meet the recommended amount of physical activity (PA) for health benefits, and this number is lower for African American students. Moreover, the correlates of PA may vary by ethnicity. Objective: In the present study, the authors tested the utility of the theory of planned behavior for explaining PA intentions and behavior in Caucasian and African American students. Participants and Methods: Participants were 238 African American (M age = 20.05 years, SD = 2.28) and 197 Caucasian (M age = 19.50 years, SD = 2.28) students who completed a baseline theory of planned behavior questionnaire and a follow-up PA measure 1 week later. Results: Hierarchical regression analyses showed that affective (β = .23) and instrumental (β = .28) attitudes and perceived behavioral control (β = .59) were significantly predictive of intention for the Caucasian students, whereas affective attitude (β = .18) and perceived behavioral control (β = .56) were significant for African American students. Furthermore, intention (β = .33) was the lone significant predictor of PA for Caucasian students, whereas perceived behavioral control (β = .23) was the significant predictor of PA for African American students. Conclusions: These data suggest that practitioners may need to consider ethnicity when developing PA interventions for college students based on the theory of planned behavior.     

Determinants Influencing Male Condom use Among University Students in Portugal

ABSTRACT. A self-administered questionnaire was carried out among university students in Portugal, with the aim to examine determinants influencing male condom use, according to the information–motivation–behavioral skills model (J. Fisher & Fisher, 1992). Students’ levels of information, motivation, and behavioral skills regarding preventive sexual behavior (male condom use) were ascertained and were used to determine their association with condom use among 880 male and 1,807 female students aged 18 to 35 years old. Although 86.9% of respondents indicated that they used a condom during their first sexual intercourse, only 32.8% used a condom always during sexual intercourse in the last 12 months. Most young people, especially women, had a good level of information regarding HIV/AIDS transmission/prevention. They also showed reasonable positive attitudes and had positive subjective norms and intentions toward HIV/AIDS preventive behaviors. Men presented a higher perceived difficulty and a lower perceived effectiveness of HIV/AIDS preventive behavior, therefore reporting higher risk acceptance. A path analysis revealed that preventive sexual behavior did not depend directly on information level but on motivation and behavioral skills (especially among men). Information about HIV prevention/transmission was not significantly associated with condom use. The finding that motivation and behavioral skills were the strongest determinants of condom use suggested that these may be important factors in effective sexually transmitted infection-prevention programs.     

The Influence of Trauma History and Relationship Power on Latinas’ Sexual Risk for HIV/STIs

ABSTRACT

A community sample of Latinas completed surveys that included measures of sexual abuse and intimate partner violence history, relationship power, negotiating power regarding condom use, perceived HIV/sexually transmitted infection (STI) risk for sexual partner, and sexual behavior. More than half of the women reported a history of intimate partner violence in the past year and/or sexual abuse in their lifetime. Intimate partner violence was correlated with lower overall sexual relationship power scores, while sexual abuse was correlated with lower condom-use negotiating power. More extensive intimate partner violence had the strongest association with higher HIV/STI risk, while controlling for relationship status, sexual abuse, and relationship power.     

Understanding factors related to nonsmoking intention among college students

Abstract

Objective: While cigarette smoking in the United States has declined, the age range of smoking initiation has risen to include young adults. This study investigated the relationship of Theory of Planned Behavior constructs (TPB; attitudes, subjective norms, and perceived behavioral control [PBC]) to nonsmoking intention among college students. Participants: Participants were 619 students at a Southeastern US university (69.8% female, 70.8% ≤ age 21, and 73.5% white). Methods: Students were recruited by email in March 2013 to participate in an online TPB-based questionnaire. Results: Future-oriented attitudes and PBC predicted higher nonsmoking intention; subjective norms did not. Moderator analyses indicated injunctive norms were more influential for occasional smokers and PBC was less influential. Conclusions: Findings suggest TPB is useful in predicting nonsmoking intention, but differentially for nonsmokers and occasional smokers. Future work should consider the health-related utility of future-oriented attitudes toward nonhealth domains and the differing beliefs of occasional smokers.