title: Sexual transmission-risk behaviour among HIV-positive persons: a multisite study using social action theory.
abstract: OBJECTIVE
  Sexual risk behaviour was explored and described using Social Action Theory.
  
  
  BACKGROUND
  The sexual transmission of HIV is complex and multi-factorial. Social Action Theory provides a framework for viewing self-regulation of modifiable behaviour such as condom use. Condom use is viewed within the context of social interaction and interdependence.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Self-report questionnaire administered to adults living with HIV/AIDS, recruited from clinics, service organizations and by active outreach, between 2010 - 2011.
  
  
  RESULTS
  Having multiple sex partners with inconsistent condom use during a 3-month recall period was associated with being male, younger age, having more years of education,substance use frequency and men having sex with men being a mode of acquiring HIV. In addition, lower self-efficacy for condom use scores were associated with having multiple sex partners and inconsistent condom use.
  
  
  CONCLUSIONS
  Social Action Theory provided a framework for organizing data from an international sample of seropositive persons. Interventions for sexually active, younger, HIV positive men who have sex with men, that strengthen perceived efficacy for condom use, and reduce the frequency of substance use, may contribute to reducing HIV-transmission risk.
authors.affiliation: University of Hawaii at Manoa School of Nursing and Dental Hygiene, Honolulu, Hawaii, USA.
authors.forename: Kathleen M
authors.identifier: http://orcid.org/0000-0002-5274-5050
authors.initials: KM
authors.lastname: Sullivan
authors.affiliation: University of California San Francisco School of Nursing, San Francisco, California, USA.
authors.forename: Carol
authors.initials: C
authors.lastname: Dawson Rose
authors.affiliation: School of Nursing, University of Ottawa School of Nursing, Ottawa, Ontario, Canada.
authors.forename: J Craig
authors.initials: JC
authors.lastname: Phillips
authors.affiliation: Rutgers State University, College of Nursing, Newark, New Jersey, USA.
authors.forename: William L
authors.initials: WL
authors.lastname: Holzemer
authors.affiliation: Case Western Reserve University School of Nursing, Cleveland, Ohio, USA.
authors.forename: Allison R
authors.identifier: http://orcid.org/0000-0002-7538-5780
authors.initials: AR
authors.lastname: Webel
authors.affiliation: Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts, USA.
authors.forename: Patrice
authors.initials: P
authors.lastname: Nicholas
authors.affiliation: Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts, USA.
authors.forename: Inge B
authors.initials: IB
authors.lastname: Corless
authors.affiliation: Nursing Strategic Initiatives Harris Health System, Houston, Texas, USA.
authors.forename: Kenn
authors.initials: K
authors.lastname: Kirksey
authors.affiliation: Rutgers State University, College of Nursing, Newark, New Jersey, USA.
authors.forename: Lucille
authors.initials: L
authors.lastname: Sanzero Eller
authors.affiliation: Frances Payne Bolton School of Nursing, Cleveland, Ohio, USA.
authors.forename: Joachim
authors.initials: J
authors.lastname: Voss
authors.affiliation: Baylor College of Medicine and AVP Texas Children's Hospital, Houston, Texas, USA.
authors.forename: Lynda
authors.initials: L
authors.lastname: Tyer-Viola
authors.affiliation: University of California San Francisco School of Nursing, San Francisco, California, USA.
authors.forename: Carmen
authors.initials: C
authors.lastname: Portillo
authors.affiliation: University of California San Francisco School of Nursing, San Francisco, California, USA.
authors.forename: Mallory O
authors.initials: MO
authors.lastname: Johnson
authors.affiliation: Ohio State University College of Nursing, Columbus, Ohio, USA.
authors.forename: John
authors.initials: J
authors.lastname: Brion
authors.affiliation: Texas A&M University-Corpus Christi, Corpus, Christi, Texas, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sefcik
authors.affiliation: Hunter College, CUNY School of Nursing, New York, New York, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Nokes
authors.affiliation: University of North Carolina at Wilmington, Wilmington, North Carolina, USA.
authors.forename: Paula
authors.initials: P
authors.lastname: Reid
authors.affiliation: University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Marta
authors.initials: M
authors.lastname: Rivero-Mendez
authors.affiliation: Yale University School of Nursing, New Haven, Connecticut, USA.
authors.forename: Wei-Ti
authors.initials: WT
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000523:psychology / Q000635:transmission*; D000073599:Health Risk Behaviors; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D057566:Self Report; D012747:Sexual Partners; D066269:Social Theory; D047568:Unsafe Sex
keywords: HIV prevention; HIV self-management; HIV-positive adults; HIV-transmission risk; Social Action Theory; condom use; nursing; self-efficacy; sexual behaviour