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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?

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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.

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Notes

  1. We did not include sexual frequency data from two participants who were extreme outliers (greater than 4 SD from the mean) on this variable.

  2. Six men reported vaginal or anal sex with both male and female partners and were included in the MSM category. We reran multivariate analyses in the MSM sample with these six men excluded and the results remained unchanged.

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Acknowledgments

We wish to thank Zulfia Chariyeva for her helpful feedback on the content of this manuscript. This work was supported by National Institute of Health (NIH) grants R01-MH069989, DK56350 and AI50410. This work was also supported in part by funding to Laura Widman from NIH/NIAID 5 T32 AI 07001-34: Training in Sexually Transmitted Diseases and HIV.

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Authors and Affiliations

  1. 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

    Laura Widman

  2. Department of Health Behavior and Health Education, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA

    Laura Widman & Carol E. Golin

  3. Division of General Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA

    Carol E. Golin

  4. Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, USA

    Carol E. Golin & Catherine A. Grodensky

  5. University of North Carolina Center for AIDS Research, Chapel Hill, USA

    Carol E. Golin

  6. Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA

    Chirayath Suchindran

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  1. Laura Widman
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  2. Carol E. Golin
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  3. Catherine A. Grodensky
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  4. Chirayath Suchindran
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Correspondence to Laura Widman.

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Widman, L., Golin, C.E., Grodensky, C.A. et al. 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?. AIDS Behav 17, 1873–1882 (2013). https://doi.org/10.1007/s10461-011-0108-7

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  • DOI: https://doi.org/10.1007/s10461-011-0108-7

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