Sexual Behavior Changes Among Heterosexual,Lesbian and Gay Bar Patrons as Assessed by Questionnaire Over an 18-Month Period

Both an original and a follow-up questionnaire study of bar patrons in Greenwich Village, New York, ascertained concern about acquiring AIDS and resultant sexual behavioral changes. In 1986 (shortly before the Koop report), almost all of the gay men sampled, a majority of the lesbian and heterosexual women, but less than a quarter of the heterosexual men reported that a concern about AIDS had affected their sexual behavior. By 1987/88, almost all of the gay men and about 80% of heterosexual men, women and lesbians reported a sexual behavior change. The greatest specific behavioral changes between the studies involved increasing reports of declining casual sex (for all groups except the gay men, more than half of whom had reported this by the first study), and a greatly increased use of condoms by heterosexuals (who had rarely used them earlier) and by gay men (who had begun using them by 1986). Variables which predict heterosexual condom use for each gender are reported.     

Sexual Behavior Among College Students in the AIDS Era

The sexual behavior of a 1988 midwestern college sample was compared to a highly similar 1982 sample to determine the impact of the AlDS epidemic. Contrary to expectations, sexual activity increased over the six-year period. More 1988 students had engaged in intercourse, and females had engaged in it more times with more partners. Age of first intercourse remained unchanged. Attitudes for both sexes became more permissive, and males also perceived their parents to have become more permissive. A continuing double-standard was suggested. For males there were increases in contraceptive frequency, contraception at last intercourse, and condom use. Increased condom use was probably not AIDS-induced, as there was no increase in use from first to last intercourse. Students' sexual, contraceptive, and verbal behavior suggested little concern about AIDS.     

Condom sales at public universities in California: implications for campus AIDS prevention

Public health officials have called for increased use of condoms to protect Americans from sexually acquiring human immunodeficiency virus (HIV) infection. To investigate the availability of condoms for sale on college campuses, we asked student union directors and bookstore managers from all 28 public universities in California, with a combined enrollment of half a million students, to complete a detailed questionnaire in August and September 1987. Two thirds of the campuses reported having condoms for sale in either their bookstores or convenience stores; one third said condoms were available in the men's and women's restrooms in their student unions. On most campuses, sales were instituted in the past year in response to the AIDS (acquired immune deficiency syndrome) epidemic. However, very few campuses provided AIDS education at the point of sale, and condoms were not easily available outside of store hours. Respondents felt that the most important obstacles to increasing the distribution of condoms on campus included concern about presenting a negative image of the university and the low priority assigned to this issue by the university administration and others on campus. This study suggests that although condom availability has improved in the past year, the opportunity exists at most California public universities to increase the distribution of condoms and improve associated AIDS-related health education efforts.     

Sexual Behavior Among College Students in the AIDS Era

The sexual behavior of a 1988 midwestern college sample was compared to a highly similar 1982 sample to determine the impact of the AIDS epidemic. Contrary to expectations, sexual activity increased over the six-year period. More students in the 1988 sample had engaged in intercourse. They had also had more partners for intercourse and more lifetime intercourse experience. Age of first intercourse remained unchanged, however. Attitudes for both sexes became more permissive and males also perceived their parents to have become more permissive. A continuing double-standard was suggested. There were increases in contraceptive frequency, in contraception at last intercourse, and use of more sophisticated contraceptive methods. Increased condom use did not appear to be AIDS-induced, as there was no increase in use from first to last intercourse. Students sexual, contraceptive, and verbal behavior suggested no obvious concern about AIDS.     

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.     

Gender, knowledge about AIDS, reported behavioral change, and the sexual behavior of college students

This article reports on an analysis of the relationships among knowledge about AIDS, self-reported changes in sexual behavior, and independent measures of those behaviors--condom use, coital frequency, and number of partners. The sample consisted of 195 sexually active, heterosexual college students attending a northeastern state university in spring 1988. With other relevant variables held constant, statistically significant associations in the predicted direction were found between knowledge and reported change and each of the dependent variables among the men, especially the men not involved in relationships. Among women, however, the only significant association was that between reporting the beginning of condom use and the frequency with which condoms were used in the past year. Possible reasons for these gender differences are discussed.     

Public opinion about AIDS policies. The role of misinformation and attitudes toward homosexuals

In an effort to better understand the cognitive and attitudinal factors underlying public opinion on AIDS-related issues, this article proposes and empirically tests a model of the relationships between (1) knowledge of HIV transmission, specifically the misinformation that AIDS can be transmitted easily through casual contact with HIV-infected persons; (2) attitudes toward homosexuals, the most prominent of the social groups presently affected by the AIDS crisis; and (3) support for restrictive public policies aimed at HIV-infected persons. Data from two nationally representative surveys conducted in December of 1985 (N = 2,308) and in July of 1987 (N = 2,095) provide evidence that misinformation about AIDS transmission and negative attitudes toward homosexuals are strong predictors of support for stringent restrictions of persons with AIDS. The findings also suggest that several background factors, in particular, education and political liberalism, may also play decisive roles in influencing levels of support for restricting those infected with the AIDS virus.     

HIV Voluntary Testing among Portuguese Women Attending Family Planning Clinics: Implications for HIV Prevention Education and Testing

ABSTRACT

Objectives: The aim of this article is to analyze the factors associated with HIV testing among 767 sexually active women. Methods: Participants were administered several self-report questionnaires that assessed behavioral and psychosocial measures. Results: Overall, 59.8% of the participants reported ever having tested for HIV. Results show that higher levels of education, being pregnant or having been pregnant, concern about AIDS, AIDS knowledge, self-efficacy in condom negotiation and perception of no risk in partner significantly predicted the likelihood of testing among women. Attending the mass was negatively associated with HIV testing. Conclusions: These findings provide information that can be used in the development of a focused gender sensitive HIV prevention program to increase HIV testing.     

Effects of a peer-led AIDS intervention with university students

Acquired immune deficiency syndrome (AIDS) has become a major health threat to university students. This study evaluated a peer-led AIDS intervention program with university students (1) increase knowledge of human immunodeficiency virus (HIV) transmission and infection; (2) change attitudes to reflect scientific information on AIDS-related facts; and (3) change behavioral intentions to correspond with safer sexual practices. Subjects were students (N = 142) from four undergraduate classes and were predominantly female (65%), white (82%), and sexually active (86%). A non-equivalent control group design was used, with two classes receiving the intervention and two classes receiving no information. For the intervention, peer educators presented AIDS-related information, modeled ways to use condoms safely and ways to discuss condom use with sexual partners, and led discussions on HIV infection and use with sexual partners, and led discussions on HIV infection and AIDS, relationships, sexuality, and condom use. A questionnaire was administered to assess differential changes in AIDS-related knowledge, attitudes, and behavioral intentions between the intervention and control groups. The results showed significant improvements among intervention subjects on the knowledge, attitudes, and behavioral intentions scales compared with the control group.     

An impact evaluation of student teacher training in HIV/AIDS education in Zimbabwe

Zimbabwe introduced a nation-wide program to teach AIDS education in 1994. This paper evaluates changes in student teachers' level of knowledge about transmission, symptoms and prevention of STDs and HIV/AIDS; their attitude towards persons living with AIDS; and their sensitivity to the impact of the epidemic and to discussing and teaching about these issues. There was an increase in knowledge of HIV prevention and in teachers' ability to discuss reproductive health and sexual issues. However, as students were exposed to other HIV material outside the programme, not all of this change is due to the programme. Course attendance needed to be enforced and the curriculum needed to be updated with student participation. Peer educators and participatory techniques are needed to get students to internalise positive attitudes and behaviour. The education materials need to address the lack of female empowerment in making decisions and negotiating for safer sex.     

Gender-specific changes in students' sexual behaviors and attitudes at a southeastern university between 1973 and 1988.

This study investigated the gender-specific, self-reported sexual behaviors and attitudes of never-married college students attending a southeastern university in 1973 and 1988. Data were collected by means of a mailed questionnaire that remained essentially unchanged for both years. The authors found that both men and women reported an increase in heterosexual relationships that included sexual intercourse and a decrease in nonsexual relationships with the other gender. The majority of the students perceived themselves as adequately informed about sexuality and satisfied with their relationships, although the proportion of men who reported being satisfied with their relationships declined over the 15 years. The students indicated that sexuality education should focus primarily on information about AIDS and on preparation for marriage.     

A multi-systemic approach to AIDS and adolescents

The AIDS epidemic poses a significant challenge for mental health professionals, educators and for society at large. Recent studies (Kennedy, 1988) have shown that AIDS has entered the adolescent population. Other studies (Hirschorn, 1987a, 1987b; Simpkins and Kushna, 1986; Weinstein, Atwood, and Rosen, in press) have shown that while college students are educated about AIDS, they inconsistently use safer sex practices. Most of the behavior change attempts have focused on the developmental psychodynamics of the adolescent stage. This paper discusses the notion that behavior change in the adolescent is not only based on the psychodynamics of the intrapersonal approaches; but, rether, that what is additionally needed is an examination of the interpersonal and social processes which support the psychodynamics of the adolescent. A multi-systemic approach to AIDS and adolescents is then presented utilizing intrapersonal, interpersonal, and social processes. This approach incorporates the school-family-community systems.     

College Students and HIV/AIDS: A Comparison of Nontraditional and Traditional Student Perspectives

Objective and Participants The authors compared nontraditional college students' knowledge and perceptions of HIV/AIDS and sexual practices with previously reported results about traditional students. Methods Nontraditional students completed an online survey with questions based on national HIV/AIDS surveys. Traditional students completed the same survey with paper and pencil. Results Overall, the authors found more similarities than differences between the 2 groups. The findings support previous research that suggests that although college students are knowledgeable about HIV and its risks, they express little personal concern about becoming infected. The authors also discuss how apparent differences between nontraditional and traditional students regarding personal concern about becoming infected, relationship status, and information sources may influence the development of effective prevention strategies geared toward nontraditional college students. Conclusions Institutional leaders need to adapt to these differences, and researchers should undertake additional studies to clarify these differences so that college students may be more effectively educated about HIV/AIDS and encouraged to get tested.     

AIDS:

A questionnaire assessing AIDS-related knowledge, attitudes and behaviors was distributed in written form and administered by telephone interviews in 1988 and again in 1990. Data were collected from members of minorities throughout Alabame. The telephone survey was based on a random sample, while the written form was distributed at targeted locations including community health centers, community action agencies, state prisons, vocational schools, and predominantly black colleges. Ninety-four percent of respondents in the telephone survey were African-American, while 84% in the written sample indicated they were African-American indicated they were African-American. Over the entire sample, knowledge and AIDS transmission was relatively accurate and increased from 1988 to 1990. Knowledge was higher in the written sample than the telephone sample at both times. The youngest and oldest age groups were least knowledgeable. In addition to knowledge, other variables including concern about contracting AIDS, behavior change, interest in learning about AIDS, and issues related to stigmatization were investigated. Implications for educational and prevention programs are discussed.     

Autocastration and autopenectomy in a patient with transsexualism and schizophrenia

Previous research focusing on changes in gay male sexual practices as a result of AIDS often avoids taking into consideration the meanings which sexual practices have within the gay community. As an alternative, the present study used a content‐analysis of personals advertisements within the personals section of The Village Voice to assess changes in the language gay men use to refer to their sexuality between the years 1978, 1982, 1985, and 1988. A significant increase in personals advertisements suggesting a concern with health is noted from 1982 to 1985. This increase continues from 1985 to 1988. Corresponding in time with these changes are increases in the number of personals advertisements which express a rejection of “stereotypical” presentations of self within the gay community. This rejection is seen as an attempt at self‐affirmation of characteristics perceived by gay men themselves as being desirable at particular historical moments. Implications for the basis of future policy interventions in reaction to AIDS are discussed. Finally, the utility of personals advertisement columns as an indicator of the meanings which people of various sexual preferences attach to their sexuality is discussed.     

Evaluation of an STD-Prevention Program for Swedish University Students

Abstract

The authors evaluated a sexually transmitted disease (STD)-prevention program that combined a mass media campaign with peer education. The program was designed to increase Swedish university students' knowledge about STDs. improve attitudes toward condom use, and tell students where to get an STD checkup. Preintervention and postintervention postal questionnaires were used with an intervention group and two types of control groups. Responses ranged from 32% to 67% for the randomly selected students and from 93% to 99% for classroom and clinic participants. The intervention was noticed by a majority of the students (85–98%) and discussed by 43% to 57%; more women than men observed and discussed the campaign. Knowledge about STDs. where to turn for STD checkups, and the intention of having an STD checkup increased. Attitudes toward condom use were equally positive before and after the intervention. Although it was successful in attracting attention and leading to discussions of STD prevention, the campaign did not encourage students to have an STD checkup.     

Counseling clients with genital herpes

The epidemic of genital herpes requires nurses to diagnose and treat human responses to this health problem (American Nurses' Association, 1980). It also creates many opportunities for nurses, particularly in the realm of counseling and education. Given the changing epidemiology of genital herpes and the psychosocial consequences, nurses need to keep abreast of new information so that they may assist people to live with the disease and teach the prevention of transmission of the disease. Recent information about mild and asymptomatic cases of herpes infections has serious implications for counseling and education of persons with genital herpes. The emergence of this "silent" dimension of herpes infections means more difficulty in diagnosis and treatment. All persons with genital herpes should be assessed for their physical and psychological responses to the disease and information should be given to combat misconceptions, to alleviate fear, and aid in preventing transmission. The most significant implication of mild or asymptomatic herpes is the greater risk of transmission. The public needs to be informed about the practice of "safer sex" as a routine measure to prevent herpes, as well as AIDS and other STDs. Given the widespread and epidemic proportions of herpes, persons should be counseled to use condoms whenever they engage in sexual activity with a partner. In addition, correct use of condoms must be taught. Nurses have an important role to play in counseling clients with genital herpes and in preventing the disease.     

Analysing the effect of public health campaigns on reducing excess weight: a modelling approach for the Spanish Autonomous Region of the Community of Valencia

Excess weight is fast becoming a serious health concern in the developed and developing world. The concern of the public health sector has lead to the development of public health campaigns, focusing on two-fold goals: to inform the public as to the health risks inherent in being overweight, and the benefits of a change in nutritional behaviour. Recent studies indicate that the effects of the average public health campaign on the target community is around 5%. In this study we aim to quantify the effect of different public health campaigns on lifestyle behaviour in the target populations in order to bring about weightloss in a significant number of people over the next few years.This study is based on recent works that consider excess weight as a consequence of the transmission of unhealthy lifestyles from one individual to another. Following this point of view, first a mathematical model is presented. Then, policies based on public health campaigns addressed to stop people gaining weight (prevention; this type of policy acts on individuals in order to maintain their weight and to stop an increase in weight) and, policies addressed to overweight individuals to reduce their weight (treatment; these campaigns act on overweight and/or obese individuals in order to reduce their weight) are simulated in order to evaluate their effectiveness. The study concludes that combination of preventive plus treatment campaigns are more effective than considering them separately.     

Changing aids‐ and fertility‐related behavior: The effectiveness of sexual education

A questionnaire was used to access the effectiveness of a ten‐week university course on human sexuality in changing students' AIDS‐ and fertility‐related behavior. The students' knowledge and behavior were evaluated (1) early in the class before there were any discussions or readings about sexual behavior, AIDS, or birth control and (2) three months later—approximately one month after completing the class. A randomly selected control group of students who did not take the class on sexuality was given the questionnaire at the same two points in time. Compared to the control group, the experimental group showed significant increases in knowledge about the likelihood of contracting the virus from one act of vaginal intercourse. The experimental group also reported increased worry about contracting AIDS from their sexual activity, while the control group did not. Further, compared with the control group, the experimental group increased certain cautious behaviors, such as being more selective in their choice of sexual partners and asking their partners more questions about their AIDS‐related behavior. However, the course did not lead students to: 1) significantly increase their use of the condom or other forms of contraception, 2) decrease their number of sexual partners, or 3) spend a longer time getting to know new partners before engaging in sexual activity. Implications for sexual education are discussed.