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A Framework for Incorporating Dyads in Models of HIV-Prevention

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Abstract

Although HIV is contracted by individuals, it is typically transmitted in dyads. Most efforts to promote safer sex practices, however, focus exclusively on individuals. The goal of this paper is to provide a theoretical framework that specifies how models of dyadic processes and relationships can inform models of HIV-prevention. At the center of the framework is the proposition that safer sex between two people requires a dyadic capacity for successful coordination. According to this framework, relational, individual, and structural variables that affect the enactment of safer sex do so through their direct and indirect effects on that dyadic capacity. This dyadic perspective does not require an ongoing relationship between two individuals; rather, it offers a way of distinguishing between dyads along a continuum from anonymous strangers (with minimal coordination of behavior) to long-term partners (with much greater coordination). Acknowledging the dyadic context of HIV-prevention offers new targets for interventions and suggests new approaches to tailoring interventions to specific populations.

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References

  1. Piot P, Bartos M, Larson H, Zewdie D, Mane P. Coming to terms with complexity: a call to action for HIV prevention. Lancet. 2008;372(9641):845–59.

    Article  PubMed  Google Scholar 

  2. Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report: Cases of HIV Infection and AIDS in the United States and Dependent Areas, 2006. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2008.

  3. Royce RA, Sena A, Cates W, Cohen MS. Sexual Transmission of HIV. N Engl J Med. 1997;336:1072–8.

    Article  CAS  PubMed  Google Scholar 

  4. Kelley HH, Berscheid E, Christensen A, et al., editors. Close relationships. New York: W. H. Freeman and Company; 1983.

    Google Scholar 

  5. Kashy DA, Kenny DA. The analysis of data from dyads and groups. In: Reis HT, Judd CM, editors. Handbook of research methods in social psychology. New York: Cambridge University Press; 2000. p. 451–77.

    Google Scholar 

  6. Reis HT, Collins WA, Berscheid E. The relationship context of human behavior and development. Psychol Bull. 2000;126:844–72.

    Article  CAS  PubMed  Google Scholar 

  7. Kelley HH, Berscheid E, Christensen A, et al. Analyzing close relationships. In: Kelley HH, Berscheid E, Christensen A, et al., editors. Close relationships. New York: W. H. Freeman and Company; 1983. p. 20–67.

    Google Scholar 

  8. Albarracín D, Johnson BT, Fishbein M, Muellerleile PA. Theories of reasoned action and planned behavior as models of condom use: a meta-analysis. Psychol Bull. 2001;127:142–61.

    Article  PubMed  Google Scholar 

  9. Johnson BT, Carey MP, Marsh KL, Levin KD, Scott-Sheldon LAJ. Interventions to reduce sexual risk for the human immunodeficiency virus in adolescents, 1985–2000: a research synthesis. Arch Pediatr Adolesc Med. 2003;157:381–8.

    Article  PubMed  Google Scholar 

  10. Johnson WD, Holtgrave DR, McClellan WM, Flanders WD, Hill AN, Goodman M. HIV Intervention research for men who have sex with men: a 7-year update. AIDS Educ Prev. 2005;17(6):568–89.

    Article  PubMed  Google Scholar 

  11. Medley A, Kennedy C, O’Reilly K, Sweat M. Effectiveness of peer education interventions for HIV prevention in developing countries: a systematic review and meta-analysis. AIDS Educ Prev. 2009;21(3):181–206.

    Article  PubMed  Google Scholar 

  12. Noar SM. Efficacy of computer technology-based HIV prevention interventions: a meta-analysis. AIDS. 2009;23(1):107–15.

    Article  PubMed  Google Scholar 

  13. Smoak ND, Scott-Sheldon LAJ, Johnson BT, Carey MP, SHARP Research Team. Sexual risk reduction interventions do not inadvertently increase the overall frequency of sexual behavior: a meta-analysis of 174 studies with 116,735 participants. JAIDS. 2006;41(3):374–84.

    PubMed  Google Scholar 

  14. El-Bassel N, Witte SS, Gilbert L, et al. The efficacy of a relationship-based HIV/STD prevention program for heterosexual couples. Am J Public Health. 2003;93:963–9.

    Article  PubMed  Google Scholar 

  15. Sullivan PS, Salazar L, Buchbinder S, Sanchez TH. Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS. 2009;23(9):1153–62.

    Article  PubMed  Google Scholar 

  16. Canin L, Dolcini MM, Adler NE. Barriers to and facilitators of HIV-STD behavior change: interpersonal and relationship-based factors. Rev Gen Psychol. 1999;3(4):338–71.

    Article  Google Scholar 

  17. Coates DL. The cultured and culturing aspects of romantic experience in adolescence. In: Furman W, Brown BB, Feiring C, editors. The development of romantic relationships in adolescence. New York, NY: Cambridge University Press; 1999. p. 330–63.

    Google Scholar 

  18. Harman JJ, Amico KR. The relationship-oriented information-motivation-behavioral skills Model: a multilevel structural equation model among dyads. AIDS Behav. 2009;13:173–84.

    Article  PubMed  Google Scholar 

  19. Misovich SJ, Fisher JD, Fisher WA. Close relationships and elevated HIV risk behavior: evidence and possible underlying psychological processes. Rev Gen Psychol. 1997;1:72–107.

    Article  Google Scholar 

  20. Ariely D, Lowenstein G. The heat of the moment: the effect of sexual arousal on sexual decision making. J Behav Decis Mak. 2006;19:87–98.

    Article  Google Scholar 

  21. NIMH Multisite HIV/STD Prevention Trial for African American Couples Group. Methodological overview of an African American couple-based HIV/STD prevention trial. JAIDS. 2008;49(1):S3–13.

    Google Scholar 

  22. NIMH Multisite HIV/STD Prevention Trial for African American Couples Group. Eban HIV/STD risk reduction intervention: conceptual basis and procedures. JAIDS. 2008;49(1):S15–27.

    Google Scholar 

  23. NIMH Multisite HIV/STD Prevention Trial for African American Couples Group. Formative study to develop the Eban treatment and comparison interventions for couples. JAIDS. 2008;49(1):S42–51.

    Google Scholar 

  24. Padian NS, O’Brien TR, Chang YC, Glass S, Francis D. Prevention of heterosexual transmission of human immunodeficiency virus through couple counseling. JAIDS. 1993;6:1043–8.

    CAS  Google Scholar 

  25. Parsons JT, Huszti HC, Crudder SO, Rich L, Mendoza J. Maintenance of safer sexual behaviors: evaluation of a theory-based intervention for HIV seropositive men with hemophilia and their female partners. Hemophilia. 2000;6:181–90.

    Article  CAS  Google Scholar 

  26. Harvey SM, Bird ST, Galavotti C, Duncan EAW, Greenberg D. Relationship power, sexual decision-making and condom use among women at risk for HIV/STDs. Women Health. 2002;36:69–84.

    Article  PubMed  Google Scholar 

  27. Harvey SM, Kraft JM, West SG, Taylor AB, Pappas-DeLuca KA, Beckman LJ. Effects of a health behavior change model-based HIV/STI prevention intervention on condom use among heterosexual couples: a randomized trial. Health Educ Behav. 2009;36(5):878–94.

    Article  PubMed  Google Scholar 

  28. Kraft JM, Harvey SM, Thorburn S, Hederson JT, Posner SF, Galavotti C. Intervening with couples: assessing contraceptive outcomes in a randomized pregnancy and HIV/STD risk reduction intervention trial. Women’s Health Issues. 2007;17:52–60.

    Article  PubMed  Google Scholar 

  29. Fishbein M. The role of theory in HIV prevention. AIDS Care. 2000;12:273–8.

    Article  CAS  PubMed  Google Scholar 

  30. Fisher JD, Fisher WA. Theoretical approaches to individual-level change in HIV behavior. In: Peterson JL, DiClemente RJ, editors. Handbook of HIV prevention. New York, NY: Kluwer Academic; 2000. p. 3–56.

    Google Scholar 

  31. Noar SM, Zimmerman RS. Health behavior theory and cumulative knowledge regarding health behaviors: are we moving in the right direction? Health Educ Res Theory Practice. 2005;20(3):275–90.

    Google Scholar 

  32. Bradbury TN, Karney BR. Intimate relationships. New York: W. W. Norton; 2010.

    Google Scholar 

  33. Bronfenbrenner U. Toward an experimental ecology of human development. Am Psychol. 1977;32:513–31.

    Article  Google Scholar 

  34. Albarracín D, Gillette J, Earl A, Glasman LR, Durantini MR, Ho MH. A test of major assumptions about behavior change: a comprehensive look at the effects of passive and active HIV-prevention interventions since the beginning of the epidemic. Psychol Bull. 2005;131:856–97.

    Article  PubMed  Google Scholar 

  35. Simpson JA, Winterheld HA, Rholes WS, Oriäna MM. Working models of attachment and reactions to different forms of caregiving from romantic partners. J Pers Soc Psychol. 2007;93(3):466–77.

    Article  PubMed  Google Scholar 

  36. Amaro H. Love, sex, and power: Considering women’s realities in HIV prevention. Am Psychol. 1995;50:437–43.

    Article  CAS  PubMed  Google Scholar 

  37. Wingood GM, DiClemente RJ. Understanding the role of gender relations in HIV prevention research. Am J Public Health. 1995;85:592.

    Article  CAS  PubMed  Google Scholar 

  38. Simpson JA. Foundations of interpersonal trust. In: Kruglanski AW, Higgins ET, editors. Social psychology: handbook of basic principles. 2nd ed. New York: Guilford; 2007. p. 587–607.

    Google Scholar 

  39. Reis HT, Shaver P. Intimacy as an interpersonal process. In: Duck SW, editor. Handbook of personal relationships: theory, research and interventions. Chichester, England: Wiley; 1988. p. 367–89.

    Google Scholar 

  40. Ickes W, Simpson JA. Motivational aspects of empathic accuracy. In: Fletcher GJO, Clark M, editors. The Blackwell handbook in social psychology: interpersonal processes. Oxford, England: Blackwell; 2001. p. 229–49.

    Google Scholar 

  41. Berscheid E, Reis HT. Attraction and close relationships. In: Gilbert DT, Fiske ST, Lindzey G, editors. The handbook of social psychology. New York, NY: McGraw-Hill; 1998. p. 193–281.

    Google Scholar 

  42. Rusbult CE, Buunk BP. Commitment processes in close relationships: an interdependence analysis. J Soc Pers Relatsh. 1993;10:175–204.

    Article  Google Scholar 

  43. Van Lange PAM, Rusbult CE, Drigotas SM, Arriaga XB, Witcher BS, Cox CL. Willingness to sacrifice in close relationships. J Pers Soc Psychol. 1997;72(6):1373–95.

    Article  PubMed  Google Scholar 

  44. Huston TL. Power. In: Kelley HH, Berscheid E, Christensen A, et al., editors. Close relationships. San Francisco: Freeman; 1983. p. 169–219.

    Google Scholar 

  45. Karney BR, Bradbury TN. The longitudinal course of marital quality and stability: a review of theory, methods, and research. Psychol Bull. 1995;118(1):3–34.

    Article  CAS  PubMed  Google Scholar 

  46. Remien RH, Wagner GJ, Dolezal C, Carballo-Dieguez A. Factors associated with HIV sexual risk behavior in male couples of mixed HIV status. J Psychol Human Sex. 2001;13(2):31–47.

    Article  Google Scholar 

  47. Wagner GJ, Remien RH, Carballo-Dieguez A. Prevalence of extradyadic sex in male couples of mixed HIV status and its relationship to psychological distress and relationship quality. J Homosex. 2000;39:31–46.

    Article  CAS  PubMed  Google Scholar 

  48. Doherty IA, Schoenbach VJ, Adimora AA. Sexual mixing patterns and heterosexual HIV transmission among African Americans in the southeastern United States. JAIDS. 2009;52(1):114–20.

    PubMed  Google Scholar 

  49. Magnus M, Kuo I, Shelley K, et al. Risk factors driving the emergence of a generalized heterosexual HIV epidemic in Washington, District of Columbia networks at risk. AIDS. 2009;23(10):1277–84.

    Article  PubMed  Google Scholar 

  50. Lenior CD, Adler NE, Borzekowski G, Tschann JM, Ellen JM. What you don’t know can hurt you: perceptions of sex-partner concurrency and partner-reported behavior. J Adolesc Health. 2006;38:179–85.

    Article  Google Scholar 

  51. Epstein H. The invisible cure: Africa, the west, and the fight against AIDS. New York: Farrar Straus & Giroux; 2007.

    Google Scholar 

  52. Leclerc-Madlala S. Cultural scripts for multiple and concurrent partnerships in southern Africa: Why HIV prevention needs anthropology. Sex Health. 2009;6(2):103–10.

    Article  PubMed  Google Scholar 

  53. Fishbein M, Ajzen I. Belief, Attitude, Intention, and Behavior: an Introduction to Theory and Research. Reading, MA: Addison-Wesley; 1975.

    Google Scholar 

  54. Kenny DA, Kashy DA, Cook WL. Dyadic data analysis. New York: Guilford; 2006.

    Google Scholar 

  55. Ajzen I, Fishbein M. Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall; 1980.

    Google Scholar 

  56. Rusbult CE, van Lange PAM. Interdependence processes. In: Higgins ET, Kruglanski A, editors. Social psychology: handbook of basic principles. New York: Guilford; 1996. p. 564–96.

    Google Scholar 

  57. CAPS. HIV prevention fact sheets: Family. Center for AIDS Prevention Studies: University of California, San Francisco; 2003.

  58. Aquilino WS. From adolescent to young adult: a prospective study of parent-child relations during the transition to adulthood. J Marriage Fam. 1997;59:670–86.

    Article  Google Scholar 

  59. Bucx F, van Wel F, Knijn T, Hagendoorn L. Intergenerational contact and the life course status of young adult children. J Marriage Fam. 2008;70(1):144–56.

    Article  Google Scholar 

  60. MacMillan R, Copher R. Families in the life course: interdependency of roles, role configurations, and pathways. J Marriage Fam. 2005;67:858–79.

    Article  Google Scholar 

  61. Tee K, Bernheim Brush AJ, Inkpen KM. Exploring communication and sharing between extended families. Int J Human-Comput Stud. 2009;67:128–38.

    Article  Google Scholar 

  62. Parke RD. Development in the family. Annu Rev Psychol. 2004;55:365–9.

    Article  PubMed  Google Scholar 

  63. Fasula AM, Miller KS. African-American and Hispanic adolescents’ intentions to delay first intercourse: parental communication as a buffer for sexually active peers. J Adolesc Health. 2006;38:193–200.

    Article  PubMed  Google Scholar 

  64. Trejos-Castillo E, Vazsonyi AT. Risky sexual behaviors in first and second generation Hispanic immigrant youth. J Youth Adolesc. 2009;38:719–31.

    Article  PubMed  Google Scholar 

  65. Perrino T, Gonzalez-Soldevilla A, Pantin H, Szapocznik J. The role of families in adolescent HIV prevention: a review. Clin Child Fam Psychol Rev. 2000;3(2):81–96.

    Article  CAS  PubMed  Google Scholar 

  66. Kirby D, Lepore G, Ryan J. Sexual risk and protective factors. Factors affecting teen sexual behavior, pregnancy, childbearing and sexually transmitted disease: Which are important? Which can you change? Washington, D. C.: The National Campaign to Prevent Teen Pregnancy; 2005.

  67. Andrews JA, Tildesley E, Hops H, Li F. The influence of peers on young adult substance use. Health Psychol. 2002;21:349–57.

    Article  PubMed  Google Scholar 

  68. Hops H, Andrews JA, Duncan SC, Duncan TE, Tildesley E. Adolescent drug use development: a social interactional and contextual perspective. In: Sameroff AJ, Lewis M, Miller SM, editors. Handbook of developmental psychopathology. 2nd ed. New York: Kluwer Academic/Plenum; 2000. p. 589–605.

    Google Scholar 

  69. Leonard KE, Kearns J, Mudar P. Peer networks among heavy, regular and infrequent drinkers prior to marriage. J Stud Alcohol. 2000;61:669–73.

    CAS  PubMed  Google Scholar 

  70. Leonard KE, Mudar P. Peer and partner drinking and the transition to marriage: a longitudinal examination of selection and influence processes. Psychol Addict Behav. 2003;17:115–25.

    Article  PubMed  Google Scholar 

  71. Karney BR, Beckett MK, Collins RL, Shaw RN. Adolescent romantic relationships as precursors of healthy adult marriages: a review of theory, research, and programs. Santa Monica, CA: RAND Corporation; 2007. Report No.: TR433-ACF.

  72. Connolly J, Furman W, Konarski R. The role of peers in the emergence of heterosexual romantic relationships in adolescence. Child Develop. 2000;71(5):1395–408.

    Article  CAS  PubMed  Google Scholar 

  73. Furman W, Simon VA, Shaffer L, Bouchey HA. Adolescents’ working models and styles for relationships with parents, friends, and romantic partners. Child Develop. 2002;73:241–55.

    Article  PubMed  Google Scholar 

  74. Collins WA, Hennighausen KC, Schmit DT, Sroufe LA. Developmental precursors of romantic relationships: a longitudinal analysis. In: Shulman S, Collins WA, editors. Romantic relationships in adolescence: developmental perspectives. San Francisco, CA: Jossey-Bass; 1997. p. 69–84.

    Google Scholar 

  75. Seiffge-Krenke IJ, Shulman S, Klessinger N. Adolescent precursors of romantic relationships in young adulthood. J Soc Pers Relatsh. 2001;18(3):327–46.

    Article  Google Scholar 

  76. Kinsfogel KM, Grych JH. Interparental conflict and adolescent dating relationships: integrating cognitive, emotional, and peer influences. J Fam Psychol. 2004;18:505–15.

    Article  PubMed  Google Scholar 

  77. Centers for Disease Control and Prevention. Sexual and reproductive health of persons aged 10–24 years—United States, 2002–2007. Morbidity and Mortality Weekly Report 2009 2009;58 (No. SS-6).

  78. Centers for Disease Control and Prevention. Surveillance Summaries MMWR 2004;53(No. SS-2).

  79. Moreno CL, El-Bassell N, Morrill AC. Heterosexual women of color and HIV risk: sexual risk factors for HIV among Latina and African-American women. Women Health. 2009;45:1–15.

    Google Scholar 

  80. Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance—United States, 2001. Morbidity and Mortality Weekly Report 2002;51:SS-4.

    Google Scholar 

  81. Grunbaum JA, Kann L, Kinchen S, et al. Youth risk behavior surveillance—United States, 2003 (Abridged). J School Health. 2004;74:307–24.

    Article  PubMed  Google Scholar 

  82. Kann L, Kinchen SA, Williams BI, et al. Special report: youth risk behavior surveillance—United States, 1999. J School Health. 2000;70:271–85.

    Article  CAS  PubMed  Google Scholar 

  83. Pantin H, Prado G, Lopez B, et al. A randomized controlled trial of Familias Unidas for Hispanic adolescents with behavior problems. Psychosom Med. 2009;71(9):987–95.

    Article  PubMed  Google Scholar 

  84. Villarruel AM, Jemmott JB, Jemmott LS. A randomized controlled trial testing and HIV prevention intervention for Latino youth. Arch Pediatr Adolesc Med. 2006;160:772–7.

    Article  PubMed  Google Scholar 

  85. Peragallo N. Latina women and AIDS risk. Public Health Nurs. 1996;13(3):217–22.

    Article  CAS  PubMed  Google Scholar 

  86. Hops H, Ozechowski T, Waldron HB, Davis BT, Turner CT, Brody J. Adolescent health-risk sexual behaviors: effects of a drug abuse intervention. 2010, submitted.

  87. Jemmott JB, Jemmott LS, Fong GT, McCaffree K. Reducing HIV risk-associated sexual behavior among African American adolescents: testing the generality of intervention effects. Am J Community Psychol. 1999;27:161–87.

    Article  PubMed  Google Scholar 

  88. Whaley AL, Davis KE. Cultural competence and evidence-based practice in mental health services. Am Psychol. 2007;62(6):563–74.

    Article  PubMed  Google Scholar 

  89. Jacobson NS, Moore D. Spouses as observers of the events in their relationship. J Consult Clin Psychol. 1981;49:269–77.

    Article  CAS  PubMed  Google Scholar 

  90. Witte SS, El-Bassel N, Gilbert L, Wu E, Chang M. Predictors of discordant reports of sexual and HIV/sexually transmitted infection risk behaviors among heterosexual couples. Sex Transm Dis. 2007;34(5):302–8.

    PubMed  Google Scholar 

  91. Noar SM, Zimmerman RS, Atwood KA. Safer sex and sexually transmitted infections from a relationship perspective. In: Harvey J, Wenzel A, Sprecher S, editors. Handbook of sexuality in close relationships. Mahwah, NJ: Lawrence Erlbaum; 2004.

    Google Scholar 

  92. Giordano PC. Relationships in adolescence. Annu Rev Sociol. 2003;29:257–81.

    Article  Google Scholar 

  93. Manning W, Longmore M, Giordano P. The relationship context of contraceptive use at first intercourse. Fam Plann Perspect. 2000;32(3):104–10.

    Article  CAS  PubMed  Google Scholar 

  94. Lescano CM, Vazquez EA, Brown LK, Litvin EB, Pugatch D. Condom Use with “Casual” and “Main” Partners: What’s in a Name? J Adolesc Health. 2006;39(3):e1–7.

    Article  Google Scholar 

  95. Ku L, Sonenstein FL, Pleck JH. The dynamics of young men’s condom use during and across relationships. Fam Plann Perspect. 1994;26:246–51.

    Article  CAS  PubMed  Google Scholar 

  96. Sayegh MA, Fortenberry JD, Shew M, Orr DP. The developmental association of relationship quality, hormonal contraceptive choice and condom non-use among adolescent women. J Adolesc Health. 2006;39(3):388–95.

    Article  PubMed  Google Scholar 

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Acknowledgments

We gratefully acknowledge James Jaccard (Florida International University), David Perez-Jimenez (University of Puerto Rico), and Gail E. Wyatt (UCLA), who contributed significantly to the discussions that led to the writing of this article. This manuscript was supported by U.S. Public Health Service grant R13-MH080619 and benefited from comments provided by attendees at the funded conference.

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Karney, B.R., Hops, H., Redding, C.A. et al. A Framework for Incorporating Dyads in Models of HIV-Prevention. AIDS Behav 14 (Suppl 2), 189–203 (2010). https://doi.org/10.1007/s10461-010-9802-0

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