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Do Behavioral Scientists Really Understand HIV-Related Sexual Risk Behavior? A Systematic Review of Longitudinal and Experimental Studies Predicting Sexual Behavior

  • Special Section: Sexual Health in Gay and Bisexual Men
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Abstract

Behavioral interventions to reduce sexual risk behavior depend on strong health behavior theory. By identifying the psychosocial variables that lead causally to sexual risk, theories provide interventionists with a guide for how to change behavior. However, empirical research is critical to determining whether a particular theory adequately explains sexual risk behavior. A large body of cross-sectional evidence, which has been reviewed elsewhere, supports the notion that certain theory-based constructs (e.g., self-efficacy) are correlates of sexual behavior. However, given the limitations of inferring causality from correlational research, it is essential that we review the evidence from more methodologically rigorous studies (i.e., longitudinal and experimental designs). This systematic review identified 44 longitudinal studies in which investigators attempted to predict sexual risk from psychosocial variables over time. We also found 134 experimental studies (i.e., randomized controlled trials of HIV interventions), but of these only 9 (6.7 %) report the results of mediation analyses that might provide evidence for the validity of health behavior theories in predicting sexual behavior. Results show little convergent support across both types of studies for most traditional, theoretical predictors of sexual behavior. This suggests that the field must expand the body of empirical work that utilizes the most rigorous study designs to test our theoretical assumptions. The inconsistent results of existing research would indicate that current theoretical models of sexual risk behavior are inadequate, and may require expansion or adaptation.

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Notes

  1. We opted to conduct a systematic review, rather than a formal meta-analysis, because of the diversity of constructs utilized as predictors of sexual risk within the literature and the relatively small number of studies that explore any single construct.

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Acknowledgements

The authors gratefully acknowledge the assistance of Karl Jennings, Kay Jenson, Adam Stoker, and Austin Weir with the literature review.

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  1. Department of Psychology, University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT, 84102, USA

    David M. Huebner & Nicholas S. Perry

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  1. David M. Huebner
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Correspondence to David M. Huebner.

Appendix

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Table 4 Databases, specific journals, and search terms used in article identification
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Huebner, D.M., Perry, N.S. Do Behavioral Scientists Really Understand HIV-Related Sexual Risk Behavior? A Systematic Review of Longitudinal and Experimental Studies Predicting Sexual Behavior. Arch Sex Behav 44, 1915–1936 (2015). https://doi.org/10.1007/s10508-015-0482-8

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