Patricia J. Morokoff

Sexual communication in relationships: when words speak louder than actions.

Sexual communication for expressing sexual desires and gathering HIV risk information were examined as interpersonal constructs related to HIV risk reduction. Community women (n = 816) with at least one heterosexual HIV risk factor (79% Euro-American, 86% some college) completed surveys assessing assertive communication with a sexual partner, HIV risk, and demographic, sexual history, interpersonal negative, and cognitive/attitudinal constructs which formed a hierarchical predictor model. In relationship context comparisons, women with a known partner HIV risk responded more negatively on most measures. Multiple regressions suggested communication is part of an overall cognitive/attitudinal approach to HIV risk, although specific predictors differ by type of communication and partner risk level. Implications for interventions considering relational context, interpersonal power, and counteracting silence are discussed.

Condom Negotiation in Heterosexually Active Men and Women: Development and Validation of a Condom Influence Strategy Questionnaire

The ability to negotiate condom use with a partner is a skill that sexually active men and women must have in order to avoid sexually transmitted diseases including HIV. Despite this fact, there is no psychometrically valid instrument in the literature to measure condom influence strategies. This investigation reports on the development and initial validation of the condom influence strategy questionnaire (CISQ). Exploratory and confirmatory analyses revealed and confirmed six influence strategies used by heterosexually active men and women to negotiate condom use. These CISQ subscales accounted for variance in safer sexual variables including sexual assertiveness, self-efficacy, and partner communication. Further, those who endorsed CISQ subscales were more likely to have intentions to use condoms consistently and to use condoms. Gender differences in subscales favoring women as the ones most likely to use influence strategies also emerged. Implications of these results as well as future directions for research are discussed.

Tailored Intervention to Increase Dual Contraceptive Method Use: A Randomized Trial to Reduce Unintended Pregnancies and Sexually Transmitted Infections

OBJECTIVE The objective of the study was to determine whether a transtheoretical model-tailored expert system intervention increases dual-method contraceptive use, compared with a nontailored educational intervention. STUDY DESIGN We performed a randomized clinical trial of 542 women at high risk for sexually transmitted infections (STIs) and unintended pregnancy. The intervention group received computer-based tailored feedback using a multimedia program. The control group received general contraceptive information and nontailored advice. RESULTS Participants in the intervention group were more likely to report use of dual contraceptive methods during follow-up (adjusted hazard rate ratio 1.70, 95% confidence interval 1.09, 2.66), compared with controls. However, there were no differences in the rates of incident STI or unintended pregnancy between the 2 groups. CONCLUSIONS The computer-based transtheoretical model-tailored intervention resulted in a 70% increase in reported dual-method contraceptive use in a group of women at high risk for STIs and unintended pregnancy. Inconsistent use of dual methods may explain the lack of effect on unintended pregnancy rates and incident STIs.

Daily moods and symptoms: effects of awareness of study focus, gender, menstrual-cycle phase, and day of the week.

Evaluated changes in daily ratings of moods and symptoms in 30 normally cycling women and 23 men. Women were randomly assigned to two groups for manipulating awareness of the study focus (aware vs. unaware). Principal-components analysis revealed six factors (Dysphoric Moods, Well-being, Physical Symptoms, Personal Space, Food Cravings, Depression) that accounted for 70% of the variance in daily ratings. Repeated-measures analyses revealed cyclic variation on each factor and no significant differences between aware and unaware women during premenstrual or menstrual phases on any measure. Unaware women reported less well-being than men during the premenstrual phase but did not differ on any other measure. Aware women did not differ from men in premenstrual or menstrual ratings on any measure. The way these findings relate to retrospective symptom reports, menstrual attitudes, and changes in moods and symptoms across the week was examined.

Dating Practices, Racial Identity, and Psychotherapeutic Needs of Biracial Women

Abstract Studies increasingly show that biracial men and women have self-identities that embrace the racial and cultural heritages of both parents (Thompson, 1999). One of the greatest dilemmas that people with biracial identities face is the question of whom they should date and marry, since they may feel strong allegiances to both of their racioethnic heritages. Few studies have examined what occurs when individuals with multiracial identities seek romantic relationships. This study provides a qualitative analysis of the dating experiences of eight biracial women (one bisexual, seven heterosexual), the social and familial relationships that influence their choice of partners, the positive and negative sociocultural aspects of having a biracial female identity, and participant perspectives about the psychotherapeutic needs of biracial women. Although results suggested that the biracial participants were receptive towards individuals of other races and more likely to appreciate differences, some participants had racial preferences regarding their choice of partners. Therapeutic considerations for professionals who work with biracial women are presented based on the findings from this study.

Sexuality in Perimenopausal and Postmenopausal Women.

This article reviews psychosocial and biological aspects of the effects of menopause on sexuality. Sexuality is conceptualized as having multiple dimensions including desire, arousal, and orgasm. Population studies have revealed that postmenopausal status is associated with decline in these components of sexual functioning. While it is probable that psychological response to menopause affects sexual functioning, little research has addressed this issue. Considerable research has addressed the possible relationship between sexuality and menopausal hormone changes. Some research shows that low estrogen levels are associated with diminished sexual response and that estrogen replacement produces enhanced sexual response. Other studies, however, do not show this. Testosterone level is more clearly related to at least some measures of sexuality. Issues for future research are discussed.

Applying the Transtheoretical Model to Ethnically Diverse Women at Risk for HIV

The purpose of this study is to compare the reliability and predictability of transtheoretical model (TTM) constructs when applied to minority and White women at risk for HIV. Participants consisted of 332 women, including Blacks, Asians, Hispanics, Native Americans, other non-Whites, and Whites. The results supported the reliability and validity of the TTM variables for minority women as well as for White women. Hierarchical multiple regressions demonstrated that TTM variables were able to predict over and above demographic variables. Structural equation models indicate strong support for a mediational model in which the pros and cons predict condom stage of change and unprotected sex though the mediation of self-efficacy. This study provides strong support for TTM scales applied to minority as well as White women at risk for HIV. The authors discuss how these variables might be incorporated into interventions aimed at increasing condom use in minority women.

Focusing on Participants

This article presents a model developed and assessed by a womens health research team to enhance sensitivity and increase readability of a survey to be used with community-based women. The survey consisted of quantitative measures of AIDS-related attitudes and behaviors, developed and used with traditional-aged college populations, and included questions of a highly personal nature. In Study 1, 30 women with English reading levels of third grade and above from two targeted community populations completed a survey in two waves of focus groups and gave feedback about readability, length, format, content, emotional responses, truthfulness in responding, and opinions about the research. Problem areas and changes that made the survey more readable, understandable, emotionally sensitive, and effective are reviewed. In Study 2, pre- and postmodification versions of nine scales are compared in 430 traditionalaged college women (pre) and 793 community-based women (post), the latter broken into subsamples for more refined comparisons. Results of five psychometric analyses demonstrate that psychometric integrity does not have to be hurt by such changes. In addition, this process illustrates how researchers can gain a better understanding of participants and their reactions to the research process through qualitative research methods.

Characteristics of smoking in low-income pregnant Latina and White women

Smoking during pregnancy is hazardous as it poses numerous risks to both the mother and the unborn child. Formerly, interventions that were successful for White smokers were thought to be equally appropriate for all smokers. It is now acknowledged that there is a need to tailor interventions for distinct ethnic and cultural groups. This study¹ was designed to identify variables that are associated with smoking status in a low-income sample of pregnant Latina and White women. Results indicate that Latinas had lower levels of addiction to cigarettes and were less likely to have partners who smoked than White women. Identifying differences in the characteristics of ethnically diverse pregnant smokers will assist in the development of interventions that are tailored for women who attend prenatal clinics.