Heather C. Huszti

A conceptual model of women's condom use intentions: Integrating intrapersonal and relationship factors.

Abstract We developed and tested a multifaceted model of condom use intentions with cross-sectional data from 435 heterosexual women at risk for HIV/STIs. In addition to traditional intrapersonal variables drawn from established models of HIV prevention (e.g. attitudes, norms, self-efficacy), the present study examined the role of relationship factors and dynamics (i.e. relationship commitment, duration, condom use and pregnancy prevention decision-making) in shaping condom use intentions. In some cases, relationship variables were directly associated with condom use intentions. In other cases their effects on condom use intentions were mediated by intrapersonal constructs. The final model accounted for 66% of the variance in condom use intentions and confirmed the importance of integrating intrapersonal variables and relationship characteristics and dynamics in understanding womens intentions to use condoms. These results offer important insights for the design of interventions directed at promoting condom use among young women at risk for HIV/STIs and underscore the need to design prevention programs that address relationship characteristics and dynamics.

Maintenance of safer sexual behaviours: evaluation of a theory‐based intervention for HIV seropositive men with haemophilia and their female partners

A theory‐based HIV risk‐reduction intervention was developed for HIV‐positive men with haemophilia and their HIV‐negative female romantic partners. The intervention was based on Prochaska and DiClemente’s Transtheoretical Model which describes behaviour change as an incremental, stage‐based process. The intervention targeted both communication about safer sex and safer sex behaviours (consistent condom use or abstinence from vaginal intercourse). A total of 255 males and 158 females from six funded haemophilia treatment centres or patient organizations (and 27 associated subsites) participated in the study. Baseline and follow‐up (15 months after baseline) measures were administered to assess safer sexual behaviours, communication about safer sex and condom self‐efficacy. A quasi‐experimental, repeated measures design was utilized to compare two naturally occurring groups; those who received the full intervention package and those who received incomplete or no intervention components. Significant intervention effects for safer sex behaviours, communication about safer sex and condom self‐efficacy were identified for the male participants, with those receiving the full intervention package demonstrating better outcomes at follow‐up. Women who received the full intervention package were more likely to report the use of a condom by their male partner during the last act of vaginal intercourse.

Determinants of Safer Sexual Behavior in a Long-term HIV-seropositive Population The Multisite Hemophilia Behavior Intervention Evaluation Project (HBIEP

Determinants of safer sexual behaviors among HIV-infected adult men with hemophilia were examined. A model was proposed that personal adjustment, communication skills, self-efficacy, and perceived advantages of condom use would influence safer sex practices. The model was tested with 181 men with hemophilia and HIV infection from 27 hemophilia treatment centers across the United States. The hypothesized model was tested using LISREL and explained 35 percent of the variance in safer sexual behaviors. Personal adjustment was significantly associated with general communication skills. General communication was linked with communication about safer sex which, in turn, influenced self-efficacy and perceived advantages of condom use. Communication about safer sex, efficacy and perceived advantages of condom use were all directly related to safer sexual behaviors.

Determinants of HIV Risk Reduction Behaviors Among Female Partners of Men with Hemophilia and HIV Infection

Determinants of safer sexual behaviors (abstinence or consistent condom use) among female partners of HIV-infected adult men with hemophilia were examined. A model was proposed predicting that emotional adjustment, communication skills, self-efficacy, and perceived advantages of condom use would influence the practice of safer sexual behaviors. Confidential surveys were completed by 119 seronegative female partners of men with hemophilia and HIV infection who received care from one of 27 hemophilia treatment centers across the United States. The proposed model was tested using LISREL, and the model explained 40% of the variance in safer sexual behaviors. Emotional adjustment was a significant predictor of both intimate and emotional communication skills. Intimate and emotional communication skills were related to self-efficacy for communicating about safer sex, which in turn influenced both communication about safer sex and perceived advantages of condom use. Communication about safer sex with a partner and perceived advantages of condom use had direct effects on safer sexual behaviors. HIV prevention interventions with women known to have seropositive partners should be multifaceted. Skill-building interventions emphasizing communication skills, increasing self-efficacy for communication about safer sex with a partner, and promoting positive attitudes about safer sex should be considered.

Safer sex decision‐making among men with haemophilia and HIV and their female partners

An exploratory qualitative study of adult heterosexual men with haemophilia and HIV and women who were their sexual partners was conducted as formative research to better understand cognitive factors involved in behavioural intentions and practices which comprise HIV risk‐reduction for sexual transmission. The study sought to generate hypotheses, uncover themes, and develop a broad perspective on possible determinants of behaviours related to HIV transmission risk reduction. Qualitative analysis of these data served as a basis for developing a subsequent quantitative, hypothesis‐testing survey and an intervention.

Critical Issues in Consultation and Liaison

An increasing number of psychologists are employed in medical settings. The most recent surveys suggest that 8%-10% of American Psychological Association (APA) members are currently working in medical settings (DeLeon, Pallak, & Hefferman, 1982;Dorken, Webb, & Zaro, 1982). This trend toward employment in medical settings appears to be continuing to increase (Stabler & Mesibov, 1984). A primary duty of many of the psychologists in medical settings is the provision of consultation services to various inpatient medical units and outpatient medical clinics.

Pediatric AIDS/HIV Infection

Pediatric acquired immunodeficiency syndrome (AIDS) is a disease with social and political ramifications that affect both research and psychotherapy with children and families. This paper examines selected clinical and ethical issues psychologists may encounter in research or psychotherapy with children, adolescents, or parents who are positive for the human immunodeficiency virus (HIV) antibody or have AIDS. A brief overview of AIDS-related research and future directions is presented with particular relevance to pediatric psychology.