title: Do safer sex self-efficacy, attitudes toward condoms, and HIV transmission risk beliefs differ among men who have sex with men, heterosexual men, and women living with HIV?
abstract: To understand sexual decision-making processes among people living with HIV, we compared safer sex self-efficacy, condom attitudes, sexual beliefs, and rates of unprotected anal or vaginal intercourse with at-risk partners (UAVI-AR) in the past 3 months among 476 people living with HIV: 185 men who have sex with men (MSM), 130 heterosexual men, and 161 heterosexual women. Participants were enrolled in SafeTalk, a randomized, controlled trial of a safer sex intervention. We found 15% of MSM, 9% of heterosexual men, and 12% of heterosexual women engaged in UAVI-AR. Groups did not differ in self-efficacy or sexual attitudes/beliefs. However, the associations between these variables and UAVI-AR varied within groups: greater self-efficacy predicted less UAVI-AR for MSM and women, whereas more positive condom attitudes--but not self-efficacy--predicted less UAVI-AR for heterosexual men. These results suggest HIV prevention programs should tailor materials to different subgroups.
authors.affiliation: Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, 130 Mason Farm Road, CB# 7030, Chapel Hill, NC 27516, USA. lwidman@email.unc.edu
authors.forename: Laura
authors.initials: L
authors.lastname: Widman
authors.forename: Carol E
authors.initials: CE
authors.lastname: Golin
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Grodensky
authors.forename: Chirayath
authors.initials: C
authors.lastname: Suchindran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology* / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D020010:Heterosexuality / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D021841:Safe Sex / Q000523:psychology*; D020377:Self Efficacy; D012737:Sex Factors; D047568:Unsafe Sex / Q000523:psychology; D055815:Young Adult