AIDS and Behavior

, Volume 2, Issue 3, pp 213–227

Psychosocial Correlates of Health-Protective Sexual Communication with New Sexual Partners: The National AIDS Behavioral Survey

  • Ariane van der Straten
  • Joseph A. Catania
  • Lance Pollack


We examined health-protective sexual communication (HPSC) with new sexual partners, in a national sample of heterosexuals. Psychosocial factors associated with HPSC were examined with the AIDS Risk Reduction Model (ARRM). Higher HPSC was related to high self-efficacy with respect to sexual activity and to condom use, and to being sexually assertive. Greater comfort with condoms, experience with HIV-preventive behaviors, and commitment to use condoms were also associated with higher HPSC, indicating that there is a strong health component in safer sex talk. Significant interactions among gender, ethnicity, and psychosocial variables underscore the importance of the cultural context in shaping HIV-preventive behaviors. Prevention efforts should address general sexual self-efficacy and encourage HPSC by developing group-specific strategies, such as increasing condom self-efficacy for women, increasing sexual comfort for Latinas, as well as emphasizing the empowering and cooperative aspect of HPSC for all.

Heterosexuals sexual communication HIV risk new relationships 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Amaro, H. (1995). Love, sex, and power. American Psychologist, 50, 437–447.Google Scholar
  2. Bandura, A. (1986). Social foundations of thought and action. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
  3. Bandura, A. (1989). Perceived self-efficacy in the exercise of control over AIDS infection. In V. M. Mays, G. W. Albee, and S. F. Schneider (Eds.), Primary prevention of AIDS: Psychological approaches. Primary prevention of psychopathology, Vol. 13 (pp. 128–141). Newbury Park, CA: Sage.Google Scholar
  4. Basen-Engquist, K. (1992). Psychosocial predictors of “safer sex” behaviors in young adults. AIDS Education and Prevention, 4, 120–134.Google Scholar
  5. Belcastro, P. A. (1985). Sexual behavior differences between Black and White students. Journal of Sex Research, 21, 56–67.Google Scholar
  6. Binson, D., Dolcini, M. M., Pollack, L. M., and Catania, J. A. (1993). Multiple sexual partners among young adults in high-risk cities. Family Planning Perspectives, 25, 268–272.Google Scholar
  7. Campbell, B. K., and Barnlund, D. C. (1977). Communication style: A clue to unplanned pregnancy. Medical Care, 15, 181–186.Google Scholar
  8. Catania, J. A., Binson, D., Dolcini, M. M., Moskowitz, J. T., and van der Straten, A. (in press). Frontiers in the behavioral epidemiology of HIV/STDs. Handbook of Health Psychology.Google Scholar
  9. Catania, J. A., Binson, D., Dolcini, M. M., Stall, R., Choi, K. H., Pollack, L. M., Hudes, E. S., Canchola, J., Phillips, K., Moskowitz, J. T., and Coates, T. J. (1995). Risk factors for HIV and other sexually transmitted diseases and prevention practices among US heterosexual adults: Changes from 1990 to 1992. American Journal of Public Health, 85, 1492–1499.Google Scholar
  10. Catania, J. A., Coates, T. J., Golden, E., Dolcini, M., Peterson, J., Kegeles, S., Siegel, D., and Thompson Fullilove, M. (1994a). Correlates of condom use among Black, Hispanic, and White heterosexuals in San Francisco: The AMEN longitudinal survey. AIDS Education and Prevention, 6, 12–26.Google Scholar
  11. Catania, J. A., Coates, T. J., and Kegeles, S. (1994b). A Test of the AIDS risk reduction model: Psychosocial correlates of condom use in the AMEN cohort survey. Health Psychology, 13, 1–8.Google Scholar
  12. Catania, J. A., Coates, T. J., Kegeles, S., Fullilove, M. T., Peterson, J., Marin, B., Siegel, D., and Hulley, S. (1992a). Condom use in multi-ethnic neighborhoods of San Francisco: The population-based AMEN (AIDS in Multi-Ethnic Neighborhoods) Study. American Journal of Public Health, 82, 284–287 [Erratum. (1992). American Journal of Public Health, 82, 998].Google Scholar
  13. Catania, J. A., Coates, T. J., Stall, R., Turner, H., Peterson, J., Hearst, N., Dolcini, M. M., Hudes, E., Gagnon, J., Wiley, J., and Groves, R. (1992b). Prevalence of AIDS-related risk factors and condom use in the United States. Science, 258, 1101–1106.Google Scholar
  14. Catania, J. A., Dolcini, M. M., Coates, T. J., Kegeles, S. M., Greenblatt, R. M., Puckett, S., Corman, M., and Miller, J. (1989). Predictors of condom use and multiple partnered sex among sexually-active adolescent women: Implications for AIDS-related health interventions. Journal of Sex Research, 26, 514–524.Google Scholar
  15. Catania, J. A., Kegeles, S. M., and Coates, T. J. (1990). Towards an understanding of risk behavior: An AIDS Risk Reduction Model (ARRM). Health Education Quarterly, 17, 53–72.Google Scholar
  16. Catania, J. A., Mc Dermott, L., and Wood, J. (1984). Assessment of locus of control: Situational specificity in the sexual context. Journal of Sex Research, 20, 310.Google Scholar
  17. Center for Disease Control (1991). HIV/AIDS Surveillance Report.Google Scholar
  18. Center for Disease Control (1995). HIV/AIDS Surveillance Report, 7, 8.Google Scholar
  19. Choi, K. H., and Catania, J. A. (1996). Changes in multiple sexual partnerships, HIV testing, and condom use among US heterosexuals 18–49 years of age, 1990–1992. American Journal of Public Health, 86, 554–556.Google Scholar
  20. Choi, K. H., Wermuth, L., and Sorensen, J. (1990). Predictors of condom use among women sexual partners of intravenous drug users. Paper presented at the VI International Conference on AIDS, San Francsico.Google Scholar
  21. Christensen, A. (1983). Intervention. In H. H. Kelley, E. Berscheid, A. Christensen, J. J. Harvey, T. L. Huston, G. Levinger, E. McClintock, L. A. Peplau, and D. R. Peterson (Eds.), Close relationships (pp. 397–448). New York: Freeman.Google Scholar
  22. Cline, R. J. W., and McKenzie, N. J. (1994). Sex differences in communication and the construction of HIV/AIDS. Journal of Applied Communication Research, 22, 322–337.Google Scholar
  23. Cline, R. W., Freeman, K. E., and Johnson, S. J. (1990). Talk among sexual partners about AIDS: Factors differentiating those who talk from those who do not. Communication Research, 17, (Special issue: Communication and the AIDS crisis), 792–808.Google Scholar
  24. Cline, R. W., Johnson, S. J., and Freeman, K. E. (1992). Talk among sexual partners about AIDS: Interpersonal communication for risk reduction or risk enhancement? Health Communication, 4, 39–56.Google Scholar
  25. Cohen, J., and Cohen, P. (1983). Applied multiple regression/correlation analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.Google Scholar
  26. Collins, B., and Aspinwall, L. (1989, May). Impression management in negotiations of safer sex. Paper presented at the Second Iowa Conference on Interpersonal Relationships, Iowa City, Iowa.Google Scholar
  27. Cupach, W. R., and Metts, S. (1991). Sexuality and communication in close relationships. In K. McKinney and S. Sprecher (Eds.), Sexuality in close relationships (pp. 93–110). Hillsdale, NJ: Erlbaum.Google Scholar
  28. Davis, C., Yarber, W., and Davis, S. (1988). Sexuality-related measures: A compendium. Lake Mills, IA: Graphic Publishing Co.Google Scholar
  29. DiClemente, R. J. (1991). Predictors of HIV-preventive sexual behavior in a high-risk adolescent population: The influence of perceived peer norms and sexual communication on incarcerated adolescents' consistent use of condoms. Journal of Adolescent Health, 12, 385–390.Google Scholar
  30. DiClemente, R. J., and Peterson, J. (1994). Preventing AIDS: Theories and methods of behavioral interventions. New York: Plenum Press.Google Scholar
  31. DiClemente, R. J., and Wingood, G. M. (1995). A randomized controlled trial of an HIV sexual risk-reduction intervention for young African-American women. Journal of the American Medical Association, 274, 1271–1276.Google Scholar
  32. Dolcini, M. M., Catania, J. A., Coates, T. J., Stall, R., Hudes, E. S., Gagnon, J. H., and Pollack, L. M. (1993). Demographic characteristics of heterosexuals with multiple partners: The National AIDS Behavioral Surveys. Family Planning Perspectives, 25, 208–214.Google Scholar
  33. Dolcini, M. M., Coates, T. J., Catania, J. A., Kegeles, S. M., and Hauck, W. (1995). Multiple sexual partners and their psychosocial correlates: The population-based AIDS in Multiethnic Neighborhoods (AMEN) Study. Health Psychology, 14, 22–31.Google Scholar
  34. Edgar, T. (1992). A compliance-based approach to the study of condom use. In T. Edgar, M. A. Fitzpatrick, and V. S. Freimuth (Eds.), AIDS: A communication perspective (pp. 47–67). Hillsdale, NJ: Erlbaum.Google Scholar
  35. Edgar, T., Freimuth, V. S., Hammond, S. L., McDonald, D. A., and Fink, E. L. (1992). Strategic sexual communication: Condom use resistance and response. Health Communication, 4, 83–104.Google Scholar
  36. Fisher, W. A., Byrne, D., White, L. A., and Kelley, K. (1988). Erotophobia-erotophilia as a dimension of personality. Journal of Sex Research, 25, 123–151.Google Scholar
  37. Freimuth, V. S., Hammond, S. L., Edgar, T., McDonald, D. A., and Fink, E. L. (1992). Factors explaining intent, discussion and use of condoms in first time sexual encounters. Health Education Research, 7, 203–215.Google Scholar
  38. Galligan, R. F., and Terry, D. J. (1993). Romantic ideals, fear of negative implications, and the practice of safe sex. Journal of Applied Social Psychology, 23, 1685–1711.Google Scholar
  39. Gerrard, M., Gibbons, F. X., and McCoy, S. B. (1993). Emotional inhibition of effective contraception. Anxiety, Stess and Coping: An International Journal, 6, 73–88.Google Scholar
  40. Gold, R. S., Karmiloff-Smith, A., Skinner, M. J., and Morton, J. (1992). Situational factors and thought processes associated with unprotected intercourse in heterosexual students. AIDS Care, 4, 305–323.Google Scholar
  41. Gómez, C. A., and Marín, B. V. (1996). Gender, culture and power: Barriers to HIV-prevention strategies for women. Journal of Sex Research, 33, 355–362.Google Scholar
  42. Gryl, F. E., Stith, S. M., and Bird, G. W. (1991). Close dating relationships among college students: Differences by use of violence and by gender. Journal of Social and Personal Relationships, 8, 243–264.Google Scholar
  43. Herold, E. S., and Mewhinney, D.-M. K. (1993). Gender differences in casual sex and AIDS prevention: A survey of dating bars. Journal of Sex Research, 30, 36–42.Google Scholar
  44. Holland, J., Ramazanoglu, C., Scott, S., Sharpe, S., and Thomson, R. (1992). Risk, power and the possibility of pleasure: Young women and safer sex. AIDS Care, 4 (Special section: Young people, HIV/AIDS and social research), 273–283.Google Scholar
  45. Kalichman, S. C., Rompa, D., and Coley, B. (1996). Experimental component analysis of a behavioral HIV-AIDS prevention intervention for inner-city women. Journal of Consulting and Clinical Psychology, 64, 687–693.Google Scholar
  46. Kelly, J. A., and Kalichman, S. C. (1995). Increased attention to human sexuality can improve HIV-AIDS prevention efforts: Key research issues and directions. Journal of Consulting and Clinical Psychology, 63, 907–918.Google Scholar
  47. Kelly, J. A., Murphy D.A., Washington, C. D., Wilson, T. S., Koob, J. J. Davis, D. R., Ledzema, G., and Davantes, B. (1994). The effects of HIV/AIDS intervention groups for high-risk women in urban clinics. American Journal of Public Health, 84, 1918–1922.Google Scholar
  48. Kirby, D. (1988). Mathtech questionnaires: Sexuality questionnaires for adolescents. In C. Davis, W. Yarber, and S. Davis (Eds.), Sexuality-related measures: A compendium. (pp. 201–212). Lake Mills, IA: Graphic Publishing Co.Google Scholar
  49. Lear, D. (1995). Sexual communication in the age of AIDS: The construction of risk and trust among young adults. Social Science and Medicine, 41, 1311–1323.Google Scholar
  50. Mays, V. M., and Cochran, S. D. (1993). Ethnic and gender differences in beliefs about sex partner questioning to reduce HIV risk. Journal of Adolescent Research, 8, 77–88.Google Scholar
  51. Metts, S., Cupach, W. R., and Imahori, T. T. (1992). Perceptions of sexual compliance-resisting messages in three types of cross-sex relationships. Western Journal of Communication, 56, 1–17.Google Scholar
  52. Metts, S., and Fitzpatrick, M. A. (1992). Thinking about safer sex: The risky business of “know your partner” advice. In T. Edgar, M. A. Fitzpatrick, and V. S. Freimuth (Eds.), AIDS: A communication perspective. Communication (pp. 1–19). Hillsdale, NJ: Erlbaum.Google Scholar
  53. MMWR. (1990). Heterosexual behaviors and factors that influence condom use among patients attending a sexually transmitted disease clinic—San Francisco. Morbidity and Mortality Weekly Report, 39, 685–689.Google Scholar
  54. Moore, J., Harrison, J. S., Kay, K. L., Deren, S., and Doll, L. S. (1995). Factors associated with Hispanic women's HIV-related communication and condom use with male partners. AIDS Care, 7, 415–427.Google Scholar
  55. Mosher, D. L., and Vonderheide, S. G. (1985). Contributions of sex guilt and masturbation guilt to women's contraceptive attitudes and use. Journal of Sex Research, 21, 24–39.Google Scholar
  56. Mosher, W., and Pratt, W. (1993). AIDS-related behavior among women 14–44 years of age: United States, 1988 and 1990. Advance Data, 239, 1–15.Google Scholar
  57. Muehlenhard, C. L. (1988). “Nice women” don't say yes and “real men” don't say no: How miscommunication and the double standard can cause sexual problems. Women and Therapy, 7 (Special issue: Women and sex therapy), 95–108.Google Scholar
  58. Muehlenhard, C. L., and Linton, M. A. (1987). Date rape and sexual aggression in dating situations: Incidence and risk factors. Journal of Counseling Psychology, 34, 186–196.Google Scholar
  59. Oakley, D., and Bogue, E. L. (1995). Quality of condom use as reported by female clients of a family planning clinic. American Journal of Public Health, 85, 1526–1530.Google Scholar
  60. Oliver, M. B., and Hyde, J. S. (1993). Gender differences in sexuality: A meta-analysis. Psychological Bulletin, 114, 29–51.Google Scholar
  61. Pinkerton, S. D., and Abramson, P. R. (1993). Evaluating the risks: A Bernoulli process model of HIV infection and risk reduction. Evaluation Review, 17, 504–528.Google Scholar
  62. Rosenfeld, L. (1979). Self-disclosure avoidance: Why I am afraid to tell you who I am. Communication Monographs, 46, 63–74.Google Scholar
  63. Stall, R., Heurtin-Roberts, S., McKusick, L., Hoff, C., and Wanner Langs, S. (1990). Sexual risk for HIV transmission among singles-bar patrons in San Francisco. Medical Anthropology, 4, 115–128.Google Scholar
  64. Tullman, G. M. (1981). The pre-and post-therapy measurement of communication skills of couples undergoing sex therapy at the Masters and Johnson Institute. Archives of Sexual Behavior, 10, 95–109.Google Scholar
  65. Weinstein, N. D., and Nicolich, M. (1993). Correct and incorrect interpretations of correlations between risk perceptions and risk behaviors. Health Psychology, 12, 235–245.Google Scholar
  66. Wells, J. W. (1989). Sexual language usage in different interpersonal contexts: A comparison of gender and sexual orientation. Archives of Sexual Behavior, 18, 127–143.Google Scholar
  67. Wenger, N. S., Greenberg, J. M., Hilborne, L. H., Kusseling, F., Mangotich, M., and Shapiro, M. F. (1992). Effect of HIV antibody testing and AIDS education on communication about HIV risk and sexual behavior. A randomized, controlled trial in college students. Annals of Internal Medicine, 117, 905–911.Google Scholar
  68. Wenger, N. S., Linn, L. S., Epstein, M., and Shapiro, M. F. (1991). Reduction of high-risk sexual behavior among heterosexuals undergoing HIV antibody testing: A randomized clinical trial. American Journal of Public Health, 81, 1580–1585.Google Scholar
  69. Wight, D. (1992). Impediments to safer heterosexual sex: A review of research with young people. AIDS Care, 4, 11–23.Google Scholar
  70. Wingood, G. M., Hunter-Gamble, D., and DiClemente, R. J. (1993). A pilot study of sexual communication and negotiation among young African American women: Implications for HIV prevention. Journal of Black Psychology, 19, 190–203.Google Scholar

Copyright information

© Plenum Publishing Corporation 1998

Authors and Affiliations

  • Ariane van der Straten
    • 1
    • 2
  • Joseph A. Catania
    • 3
    • 2
  • Lance Pollack
    • 3
  1. 1.Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of CaliforniaSan Francisco
  2. 2.Center for AIDS Prevention Studies (CAPS)San Francisco
  3. 3.Department of MedicineUniversity of CaliforniaSan Francisco

Personalised recommendations