                           AIDS NEWS SERVICE
                      Michael Howe, MSLS, Editor
                        AIDS Information Center
                   VA Medical Center, San Francisco
                        (415) 221-4810 ext 3305
                           October 14, 1994

                 Safer Sex: Information for Counselors
                               (Part IX)

                         References - Condoms
                         Psychological Aspects

Adib, S. Maurice; Joseph, Jill G.; Ostrow, David G.; Tal, Margalit;
and others.
      Relapse in sexual behavior among homosexual men: A 2-year
follow-up from the Chicago MACS/CCS. AIDS, 1991 Jun, v5
(n6):757-760.

Abstract: Studied the prevalence of safer sexual practices among
724 homosexual men assessed over 1-yr (1986-1987) and 2-yr
(1986-1988) periods who participated in the Chicago Multicenter
AIDS Cohort Study/Coping and Change Study (MACS/CCS). The most
consistent finding was the increasing trend toward abstinence of
both receptive (RAS) and insertive anal sex (IAS). 52% of the
Subjects in 1986 and 68% in 1988 reported avoiding RAS. In 1986,
44% of the Subjects were HIV-seropositive; this varied little over
time. In 1986, HIV-seropositive Subjects were twice as likely to
engage in unsafe practices than seronegative Subjects. However, the 
proportion of seropositives practicing safer sex increased, so that 
differences in practices between this group and seronegatives
disappeared by 1987. 53% of the Subjects maintained safer sexual
practices in RAS over 1 yr (47% in IAS). Relapse rates were 31% for
RAS and 35% for IAS.

Catania, Joseph A.; Coates, Thomas J.; Golden, Eve; Dolcini, M.
Margaret; and others.
      Correlates of condom use among Black, Hispanic, and White
heterosexuals in San Francisco: The AMEN longitudinal study. AIDS
Education & Prevention, 1994 Feb, v6 (n1):12-26.

Abstract: Examined correlates of condom use in a longitudinal
sample of 716 White, Black, and Hispanic heterosexuals (aged 20-44
yrs) with an HIV risk factor in San Francisco. The AIDS in
Multi-Ethnic Neighborhoods (AMEN) survey examined the distribution
of HIV infection and HIV risk behaviors across groups defined by
race, gender, and sexual orientation. High levels of condom use
were associated with labeling one's sexual behavior as risky for
HIV infection, high levels of condom enjoyment, and commitment to
use condoms, good sexual communication practices, gender (trend),
and marital status. Results support the need for wide-ranging
intervention programs that stimulate people to make personal risk
assessments, teach basic sexual skills, and direct those in need
of intensive help to appropriate agencies.

Catania, Joseph A.; Coates, Thomas J.; Peterson, John; Dolcini, M.
Margaret; and others.
      Changes in condom use among Black, Hispanic, and White
heterosexuals in San Francisco: The AMEN cohort survey. Journal of
Sex Research, 1993 May, v30 (n2):121-128.

Abstract: Examined changes in condom use over a 1-yr period among
heterosexual Whites, Blacks, and Hispanics (aged 20-45 yrs) with
an HIV related risk factor in a community-based longitudinal sample
( n = 716). Heterosexuals with a risk factor made only marginal
gains toward increasing their condom use to highly efficacious
levels (100% use) from Wave 1 to 2 (4% net increase). Blacks,
people without a primary partner, and the never married were
significantly more likely than other social strata to increase 
condom use from low-moderate use at Wave 1 to always using condoms 
at Wave 2. Nevertheless, changes across social strata remain modest
with iv drug users and Hispanic women showing negative or no
change. The young and highly educated were the most likely to
maintain moderate to high levels of condom use over time.

Catania, Joseph A.; Coates, Thomas J.; Stall, Ron; Turner, Heather;
and others.
      Prevalence of AIDS-related risk factors and condom use in the
United States. Science, 1992 Nov, v258 (n5085):1101-1106.

Abstract: Obtained telephone interview data from 8,263 Subjects
(aged 18-75 yrs) on the prevalence of HIV-related risks, on the
distribution of the 3 largest risk groups across social strata,
and on the prevalence and distribution of condom use among
heterosexuals reporting a risk factor. 15-31% of Subjects
nationally and 20-41% in cities with a high prevalence of AIDS
reported an HIV risk factor. Condom use was relatively low. Results
suggest that current HIV prevention programs have, to a limited
extent, reached those heterosexuals with multiple sexual partners
but have failed to reach many other groups of the heterosexual
population at risk for HIV.

Choi, Kyung-Hee; Wermuth, Laurie A.
      Unsafe sex and behavior change. IN:  Preventing AIDS in drug
users and their sexual partners. The Guilford substance abuse
series. (James L. Sorensen, Laurie A. Wermuth, David R. Gibson,
Kyung-Hee Choi, Joseph R. Guydish, Steven L. Batki),  Guilford
Press, New York, NY, US. 1991. p. 43-61.

Abstract: (from the introduction) emphasize that drug users and
their sexual partners risk transmitting HIV (human immunodeficiency
virus) through their sexual behaviors; describe (hetero)sexual
behaviors that are risky for transmitting HIV, as well as the
difficulties associated with behavioral changes among injection
drug users and their sexual partners... in describing AIDS
(acquired immune deficiency syndrome) risk behaviors, they
critically examine what is known about the risk to sexual partners,
the risks of sexual practices, and perceptions of AIDS risk; extend
these issues to the difficulties associated with changing risky
sexual behaviors; give special attention to the extent of condom
use and factors influencing the use of condoms.

de Graaf, R.; Vanwesenbeeck, I.; Van Zessen, G.; Straver, C. J.;
and others.
      Condom use and sexual behaviour in heterosexual prostitution
in the Netherlands. AIDS, 1992 Oct, v6 (n10):1223-1226.

Abstract: Examined the extent to which unsafe sex occurs within
the various types of prostitution in the Netherlands and to what
extent these types of prostitution are linked sexually. Subjects
were 127 adult prostitutes and 91 adult clients. In the previous
12 mo, home, street, and window prostitutes reported having 
commercial protected intercourse less consistently than escorts or
prostitutes at clubs or brothels. 10% of all prostitutes and 12%
of all clients engaged in both unsafe commercial and private sex,
potentially spreading HIV to the general population.

de Wit, J. B. F.; Sandfort, Th. G./M.; de Vroome, E. M. M.; van
Griensven, G. J. P.; and others.
      The effectiveness of condom use among homosexual men. AIDS,
1993 May, v7 (n5):751-752.

Abstract: Interviewed 671 homosexual men to investigate the failure
rate of condoms in relation to the type of condom and lubricant
used, and to examine the extent to which psychosocial and
sociodemographic factors influence the occurrence of condom
failure. Personal efficacy, with regard to Subjects putting on a
condom themselves, was significantly related to the occurrence of
condom failure. Subjects who found this difficult experienced a
higher failure rate.

Detels, Roger; Visscher, Barbara R.; Jacobson, Lisa P.; Kingsley,
Lawrence A.; and others.
      Sexual activity, condom use, and HIV-1 seroconversion. IN: 
AIDS and sex: An integrated biomedical and biobehavioral approach.
Kinsey Institute series, Vol. 4.; Bruce R. Voeller, June Machover
Reinisch, Michael S. Gottlieb, Eds.  Oxford University Press, New
York, NY, US. 1990. p. 13-19.

Abstract: (from the chapter) report ...the relationship of specific
sexual activities and condom use to the HIV-1 (human
immunodeficiency virus) seroconversion rate over the first 2 years
of follow-up of the ...(homosexual and bisexual) men who are
seronegative at first visit to the MACS (Multicenter AIDS (acquired
immune deficiency syndrome) Cohort Study).

DiClemente, Ralph J.
      Psychosocial determinants of condom use among adolescents. 
IN:  Adolescents and AIDS: A generation in jeopardy.; Ralph J.
DiClemente, Ed.  Sage Publications, Inc, Newbury Park, CA, US.
1992. p. 34-51.

Abstract: (from the preface) focuses on identifying and
understanding the role of psychosocial and behavioral factors
associated with HIV-preventive sexual behavior (i.e., consistent
condom use) (in adolescents). (from the chapter) review studies
that evaluated the relative influence of a number of factors to
predict condom use among adolescents; each study will be reviewed
in turn, and an overarching synthesis of the findings will be
described in a summary section; methodological limitations inherent
in the design of these studies also will be discussed; presents
recommendations for developing more effective HIV-prevention
interventions.

Ehrhardt, Anke A.; Yingling, Sandra; Zawadzki, Rezi; Martinez-
Ramirez, Maria.
      Prevention of heterosexual transmission of HIV: Barriers for
women. Special Issue: Sexual transmission of HIV infection: Risk 
reduction, trauma, and adaptation. Journal of Psychology & Human
Sexuality, 1992, v5 (n1-2):37-67.

Abstract: Conducted 11 focus groups with a total of 78 19-45 yr
old women (primarily Latinas and Black) from high HIV
seroprevalence eighborhoods. Results suggest that HIV interventions
for women must consist of sex education, including anatomy and
physiology. Sexual negotiation skills must be taught and HIV
prevention messages must address many women's desire for pregnancy.
Development of new HIV prevention strategies must focus on methods
under women's control that are outside of negotiation with a male
sex partner.

Griffore, Robert J.; Kallen, David J.
      AIDS and college students: Toward effective prophylactic use
of condoms. College Student Journal, 1990 Dec, v24 (n4):341-344. 

Abstract: Argues that information-based approaches to controlling
the spread of the human immunodeficiency virus (HIV) and acquired
immune deficiency syndrome (AIDS) in the college student population
are not likely to result in sufficient or reliable behavior change.
College students must be given the opportunity to develop skills
and strategies of behavioral self-management, and they must direct
these skills and stategies toward appropriate use of condoms as
prophylactics.

Hanson, Meredith; Cancel, John; Rolon, Ana.
      Reducing AIDS risks among dually disordered adults. Research
on Social Work Practice, 1994 Jan, v4 (n1):14-27.

Abstract: Evaluated a social group work intervention designed to
help dually disordered (substance use and mental disorders) adults
change sexual behaviors that increase their risk of HIV infection.
30 clients attending a day treatment program for dually disordered
adults participated in an AIDS awareness and prevention group.
Using a nonequivalent control group evaluation design, Subjects
were systematically assigned to either the 1st cycle of the group
or to a waiting list. Findings show that, compared with persons on
the waiting list, Subjects who received the preventive intervention
improved their understanding of correct condom use, used condoms
more often, reduced risky sexual practices, and were more assertive
in sexual encounters. Behavioral changes were attributable to group
involvement and not the clients' pregroup characteristics.

Jayasuriya, D. C.
      The formulation and implementation of a national policy on
condoms in the context of HIV/AIDS: A review. AIDS Care, 1991, v3
(n1):3-9.

Abstract: The acquired immune deficiency syndrome (AIDS) pandemic
has brought into sharp focus the role of condoms in preventing the
transmission of the human immunodeficiency virus (HIV). In the vast
majority of countries, the condom prevalence rate is very low and
to varying extents socio-cultural, infrastructure and logistics,
quality control and incorrect usage problems have made it difficult
to promote the use of condoms. It is only by developing a national
policy on condoms that countries could mobilize within a short span
of time all the resources to ensure that condoms are used by those
who are at risk of contracting or transmitting the HIV. The
conditions necessary to develop such a policy and the elements of
the policy are described.

Keller, Mary L.
      Why don't young adults protect themselves against sexual
transmission of HIV? Possible answers to a complex question.    
AIDS Education & Prevention, 1993 Fall, v5 (n3):220-233.

Abstract: Examined risk taking regarding HIV infection among young
adults by assessing representations of HIV, problems in using
condoms and feeling comfortable with safer sex practices, and
situational factors associated with at-risk sexual behavior. 272
college students completed a questionnaire developed for the study.
Representations of HIV lacked the information necessary to guide
sexual behavior. Subjects were aware of the causes of sexual
transmission of HIV, but many indicated uncertainty about the
effectiveness of preventive strategies. A number of specific
problems with using condoms were cited by the Subjects. The
majority of Subjects (85.3%) reported at least 1 occurrence of
unprotected sexual intercourse. For 60% of them, the stated reason
for risk taking was that the intercourse was unplanned or
spontaneous; 50% said they "just knew" the partner was safe and
not infected with HIV.

Kennedy, Cheryl A.; Skurnick, Joan; Wan, Jim Y.; Quattrone, Gloria;
and others.
      Psychological distress, drug and alcohol use as correlates on
condom use in HIV-serodiscordant heterosexual couples. AIDS, 1993
Nov, v7 (n11):1493-1499. 

Abstract: Studied the relationship of psychological distress and
drug and alcohol habits to condom use in 106 serodiscordant
heterosexual couples, using the Brief Symptom Inventory.
HIV-positive men who scored higher on Interpersonal Sensitivity
items were less likely to use condoms. HIV-positive men who used
condoms were younger, had higher educational levels, tended not to
receive public assistance, and were not regular drinkers.
HIV-negative men who did not use condoms were more likely to be
drug users and to combine drugs with sex. HIV-positive women who
used condoms tended to be married and to have higher household
incomes. They were less likely to be drug users. HIV-positive women
who used condoms were more anxious and had lower hostility scores.
For HIV-negative women condom use was correlated with being
employed. These condom users were not regular drinkers, were less
likely to combine drugs and sex, and had fewer drug problems. 

Lule, G. S.; Gruer, L. D.
      Sexual behaviour and use of the condom among Ugandan students.
AIDS Care, 1991, v3 (n1):11-19.

Abstract: A questionnaire was completed by 661 male and 270 female
university undergraduates. More than 60% of the men and 36% of the
women reported at least 2 sexual partners in the past year. Over
18% of respondents reported at least one episode of sexually
transmitted disease in the past year. Most respondents correctly
identified the main routes of human immunodeficiency virus (HIV)
transmission but risk was also often incorrectly associated with
non-penetrative sex. Only a minority saw the condom as an effective
preventive method: most saw it as unsafe or as an encouragement to
promiscuity. The condom was approved of by only one quarter of
respondents.

MacDonald, Peter Francis.
      Predictive model of college undergraduates' intent to engage
in risk reduction behavior regarding AIDS. Dissertation Abstracts
International, 1993 Mar, v53 (n9-A):3113.

Malow, Robert M.; Corrigan, Sheila A.; Cunningham, Stacey C.; West,
Jeffrey A.; and others.
      Psychosocial factors associated with condom use among
African-American drug abusers in treatment. AIDS Education &
Prevention, 1993 Fall, v5 (n3):244-253.

Abstract: Evaluated the relationship between condom use and various
psychological and behavioral factors among 136 heterosexual,
African-American, cocaine-dependent men within the context of the
AIDS Risk Reduction Model. AIDS prevention knowledge was assessed
by the Knowledge of AIDS Risk Test, the AIDS/HIV Prevention
Questionnaire, the AIDS Risk Battery, and a behavioral
demonstration test. The 52 Subjects who used condoms reported
significantly higher levels of self-efficacy, condom use skills,
and sexual communication with sexual partners than did the 84
Subjects who did not use condoms. The groups did not differ in
perceived susceptibility, anxiety concerning HIV transmission,
response efficacy, or knowledge regarding HIV.

McKusick, Leon; Hoff, Colleen C.; Stall, Ronald; Coates, Thomas J. 
      Tailoring AIDS prevention: Differences in behavioral
strategies among heterosexual and gay bar patrons in San Francisco.
AIDS Education & Prevention, 1991 Spring, v3 (n1):1-9.

Abstract: Three groups of bar patrons (314 heterosexual men, 437
heterosexual women, and 593 gay men) in San Fransisco were compared
on 4 sexual risk reduction strategies for acquired immune
deficiency syndrome (AIDS). The strategies were safer sex practices
(particularly adoption of the use of condoms), reducing the number
of sexual partners, taking the human immunodeficiency virus (HIV)
antibody test, and determining the characteristics of a potential
sexual partner. Heterosexuals reported fewer sex partners and were
more likely than gay men to interview potential partners. Gay men
were more likely to use condoms and the HIV antibody test than
their heterosexual counterparts.

Metts, Sandra; Fitzpatrick, Mary Anne.
      Thinking about safer sex: The risky business of "know your
partner" advice. IN:  AIDS: A communication perspective.
Communication.; Timothy Edgar, Mary Anne Fitzpatrick, Vicki S.
Freimuth, Eds.  Lawrence Erlbaum Associates, Inc, Hillsdale, NJ,
US. 1992. p. 1-19. 

Abstract: (from the chapter) illustrate the embedded and dynamic
nature of condom use (for HIV prevention) by situating it within
a cognitive model based on scripts and plans; the model presumes
that the prevailing sexual script warrants against condom use
because condoms disrupt the passion of the moment, they signify
ghosts of lovers past, and particularly because they symbolize the
possibility that one or both partners are infected with the AIDS
virus; although the prevailing script does include a "getting to
know each other" phase that allows for explicit questions about a 
potential partner's use of condoms, the pressure to be socially  
appropriate leads people to assess less relevant features of a   
target--typically his or her suitability as a rational (rather than 
sexual) partner... a phenomenological definition of safer sex; a
cognitive perspective on sexual communication; plans to use
condoms; implications for prevention.

Moatti, Jean-Paul; Bajos, Nathalie; Durbec, Jean-Pierre; et al.
      Determinants of condom use among French heterosexuals with
multiple partners. American Journal of Public Health, 1991 Jan,
v81 (n1):106-109.

Abstract: 1,008 French heterosexuals (aged 18-49 yrs) with multiple
partners were interviewed about risk perception of HIV
transmission, sexual behavior, and condom use. Systematic or
occasional use of condoms during the previous 12 mo was reported
by 46.9% of Subjects. Among the 473 condom users, 38.7% said they
had never used condoms before the last 12 mo. Fear of AIDS rather
than contraception was the main motivation of these recent users.
Voluntary testing for HIV, average or more than average fear of
sexually transmitted diseases, and knowledge of HIV carrier in
personal relations were associated with condom use. Nonusers
expressed more concern than users about the social and cultural
images of condoms.

Moses, Stephen; Plummer, Francis A.; Ngugi, Elizabeth N.;
Nagelkerke, Nico J.; and others.
      Controlling HIV in Africa: Effectiveness and cost of an
intervention in a high-frequency STD transmitter core group. AIDS,
1991 Apr, v5 (n4):407-411.

Abstract: Demonstrated that a large reduction in human
immunodeficiency virus (HIV) transmission can be achieved through
an inexpensive intervention program among a cohort of 1,000 female
prostitutes in the low-income Pumwani area of Nairobi. Condom use
prevented or delayed HIV infection in initially uninfected
Subjects, and thus kept them out of the pool of HIV transmitters.
Using condoms also reduced genital ulcer (due to other sexually
transmitted diseases, which increases the probability of HIV
transmission) transmission. Early treatment of ulcers shortened
their duration, so that the chances of spreading the infection
should have been reduced even at times when condoms were not used.
Costs of the program are evaluated by comparing them with the costs
of caring for an individual with acquired immune deficiency
syndrome (AIDS).

Nzila, Nzilambi; Laga, Marie; Thiam, Manoka A.; Mayimona, Kivuvu;
and others.
      HIV and other sexually transmitted diseases among female
prostitutes in Kinshasa. AIDS, 1991 Jun, v5 (n6):715-721.

Abstract: Collected data from 693 hotel prostitutes (HPs), 448 home
prostitutes (HMPs), and 85 street prostitutes (SPs) in Zaire. Most
Subjects reported taking some preventive measures against sexually
transmitted diseases (STDs), but only 11% of HPs, 9% of HMPs, and
31% of SPs mentioned condom use as a way of preventing STDs. Oral
and vaginal medication were used frequently to prevent STDs. 99%
of the Subjects had heard about acquired immune deficiency syndrome
(AIDS), but only 77% knew that sex was the predominant mode of
transmission. 75% of the Subjects had at least one STD, and 35% of
the Subjects tested positive for human immunodeficiency virus
(HIV). Because STDs may enhance transmission of HIV, prostitutes
who have a high prevalence of both HIV and other STDs may be at
high risk of acquiring and transmitting HIV. Interventions aimed
at increasing condom use and lowering levels of STDs should be
targeted at this population.

Obbo, Christine.
      HIV transmission: Men are the solution. Population &
Environment: A Journal of Interdisciplinary Studies, 1993 Jan, v14
(n3):211-243.

Abstract: Outlines the historical and cultural context of the
practices and attitudes that hinder change in male sexuality in
Uganda. The data suggest that effective control of HIV transmission
depends on men changing their attitudes toward female sexuality.
Condoms have been scarce in Uganda because there is no great demand
for them by men. Women think the condoms might be their salvation
from "the death sentence of AIDS." Effective AIDS education
requires transformation in thinking. The double standard, which is
conveniently endorsed by men, enables men to have an option in the
number of sexual and marriage partners they can enjoy. Women are
denied such options.

Pivnick, Anitra.
      HIV infection and the meaning of condoms. Special Issue:
Women, poverty and AIDS. Culture, Medicine & Psychiatry, 1993 Dec,
v17 (n4):431-453.

Abstract: Describes activities and constructions of meaning
associated with condom use among 126 drug-using Black and Latino
female methadone patients and their long-term sexual partners. A
greater proportion of Subjects did not use condoms with husbands
(64%) compared to those who did not use condoms with lovers (38%).
HIV positive Subjects were more likely to have informed their
spouses of their HIV infection, whereas they were less inclined to
have shared their positive serostatus with their lovers. Present
day meanings associated with condom use include loss of male
protection, violations of constructions of intimacy, fidelity,
conjugal bonding, female identity, illness, and death. It is argued
that efforts to change condom use patterns must be based on
increased vocational, educational, and social opportunities for
women and a recontextualization of attitudes, behaviors, and
beliefs.

Roper, William L.; Peterson, Herbert B.; Curran, James W.
      Commentary: Condoms and HIV/STD prevention: Clarifying the
message. American Journal of Public Health, 1993 Apr, v83
(n4):501-503.

Abstract: Argues that correct and consistent use of condoms is
highly effective in preventing sexually transmitted HIV infection
and other sexually transmitted diseases. Assertions that minimize
the potential efficacy of condoms may be self-fulfilling
prophecies, because condoms may be used less consistently by those
who do not believe them to be effective.

Sherr, Lorraine; Strong, Colin; Goldmeier, David.
      Sexual behaviour, condom use and prediction in attenders at
sexually transmitted disease clinics: Implications for counselling.
Special Issue: Sexual and marital counselling: Perspectives on
theory, research...  Counselling Psychology Quarterly, 1990, v3
(n4):343-352.

Abstract: Surveyed 260 attenders at a sexually transmitted disease
clinic to examine sexual behavior, condom use, and appraisal and
to determine whether situational factors in their last sexual
encounters were predictive of condom use. Response to health
education campaigns promoting condoms in the light of human
immunodeficiency virus (HIV) were also examined. Risk exposure was
consistently high. Despite messages about condoms and safe sex,
there was consistent evidence of unprotected anal and vagnial
intercourse. Difficulties with condoms were widespread and fell
into physical and psychological categories. The only predictor of
condom use was the desire for unprotected sex. Differences between
responses for heterosexual and homosexual men and women were
examined. The psychological bases for beliefs underlying high-risk
sexual behavior may be a target for counseling interventions.

Sobo, E. J.
      Inner-city women and AIDS: The psycho-social benefits of
unsafe sex. Special Issue: Women, poverty and AIDS. Culture,
Medicine & Psychiatry, 1993 Dec, v17 (n4):455-485.

Abstract: Describes the preliminary findings from an ongoing
anthropological exploration of the links between inner-city Black
women's ( N = 13) experiences and understandings of heterosexual
relationships and condom use rates. The research identified and
explored psychosocial barriers to safer sex. HIV/AIDS risk denial
was examined, especially as it relates to women's strategic use of
unsafe (condomless) sex and "monogamy narratives" to build and to
maintain this denial. Research findings suggest that sponsoring
group meetings in which women can talk to each other about
HIV/AIDS, reducing women's dependence on men, and adjusting
HIV/AIDS education curricula to better meet the needs of urban
minority women are useful ways to increase safer sex practices in
this population.

Spina, M.; Serraino, D.; Tirelli, U.
      Condom use in high-risk sexual practices of female prostitutes
in Italy. AIDS, 1992 Jun, v6 (n6):601-602.

Abstract: Evaluated the use of condoms and high-risk sexual
practices (HSPs) with clients and nonpaying partners in a sample
of 53 female prostitutes (47 non-iv drug users and 6 iv drug users)
in 7 Italian towns from 1989 to 1991. 52 Subjects reported always
using a condom with their clients, while only 2 used condoms with
their nonpaying partners. HSPs were reported more for nonpaying
partners than for clients.

Stokes, Joseph P.; McKirnan, David J.; Burzette, Rebecca G.
      Sexual behavior, condom use, disclosure of sexuality, and
stability of sexual orientation in bisexual men. Journal of Sex
Research, 1993 Aug, v30 (n3):203-213.

Abstract: Studied 105 self-identified bisexual men (aged 19-62 yrs)
recruited through a newspaper and interviewed in person concerning
social characteristics, sexual behavior, rates of disclosure of 
sexuality to others, behavioral vs self-labeling definitions of
bisexuality, HIV-risk behavior, and stability of sexual
orientation. HIV-risk behavior was generally low. Most respondents 
had not disclosed their same-sex attraction to their social
networks, including female sexual partners. Behaviorally bisexual
men had higher psychological well-being and lower HIV risk than did
men who self-identified as bisexual but did not meet a behavioral
criterion. Among respondents recontacted 1 yr after the original
interview, 40% had changed toward a more homosexual self-identity.

Thomas, Stephen B.; Hodges, Bonnie C.
      Assessing AIDS knowledge, attitudes, and risk behaviors among
Black and Hispanic homosexual and bisexual men: Results of a
feasibility study. Journal of Sex Education & Therapy, 1991 Summer,
v17 (n2):116-124. 

Abstract: Surveyed 91 gay and bisexual men (62.7% Black, 36.1%
Hispanic). 72.2% of the Subjects had been tested for
humanimmunodeficiency virus (HIV) antibodies. 95.6% knew where to
go to be tested. Reasons for not being tested are noted. 34% of
the Subjects reported having had sex with someone who has HIV+ or
was diagnosed with acquired immune deficiency syndrome (AIDS). 90%
of respondents knew that correct use of condoms offers protection
from HIV infection. However, knowledge about the effectiveness of
various types of condoms varied. Subjects' knowledge about the 
sexual transmission of HIV is discussed. Oral sex was the most
frequently reported sexual behavior. The use of a community-based
organization charged to reach Black and Hispanic gay men is
recommended.

Uitenbroek, Daan G.; McQueen, David V.
      Changing patterns in reported sexual practices in the
population: Multiple partners and condom use. AIDS, 1992 Jun, v6
(n6):587-592.

Abstract: Investigated whether the pattern of change with regard
to condom use and number of partners is similar or different by
gender and education. Telephone interviews were conducted with
5,149 females and 4,267 males (aged 18-45 yrs) in Scotland. Data
were collected 5 days per week from 1987 to 1990. Educational level
was assessed by asking at what age Subjects finished full-time
education. Condom use increased for both sexes among more educated
Subjects. Among less educated, multiple-partner Subjects, there was
an increase in condom use (more so among women than men), while a
decrease in condom use was observed among less educated,
nonmultiple-partner Subjects. Results suggest that a concern with
both elements of sexual behavior (condom use and limiting the
number of partners) might slow the transmission of HIV.

Van den Hoek, Anneke; Van Haastrecht, Harry J.; Coutinho, Roel A.
      Heterosexual behaviour of intravenous drug users in Amsterdam:
Implications for the AIDS epidemic. AIDS, 1990 May, v4
(n5):449-453.

Abstract: Assessed the possibility of the spread of human
immunodeficiency virus (HIV) from iv drug users (IVDUs) to their
heterosexual partners by studying the frequency and type of sexual
practices and the use of condoms with private steady or casual
partners or with commercial partners. The majority of the 243 IVDUs
who were interviewed were heterosexually active, and their partners
appeared to be at risk for HIV infection only through sexual
contact with the IVDUs. Vaginal intercourse was the most popular
form of sexual contact in all relationships studied, and reported
condom use was infrequent. Sexually transmitted diseases were
common in Subjects with or without a history of prostitution. IVDUs
may be an important source for heterosexual transmission of
acquired immune deficiency syndrome (AIDS).

Watkins, Katherine E.; Metzger, David; Woody, George E.; McLellan,
A. Thomas; and others.
      Determinants of condom use among intravenous drug users. AIDS,
1993 May, v7 (n5):719-723.

Abstract: 158 iv drug users were each questioned about their 3 most
recent sexual partners, about the circumstances associated with the
last time they had sexual intercourse with one of those partners,
and about condom use with each partner during the most recent
episode of intercourse. Independent variables used to predict
condom use were divided into 3 categories: Subject characteristics
(including demographics and drug use and related behaviors), a
situational characteristic (whether drugs or alcohol were used
before intercourse), and partner characteristics (e.g., partner's
use of drugs). Condom use during the most recent sexual experience
was reported by 34% of Subjects. Being HIV-positive predicted
condom use, and condoms were more likely to be used with a casual
partner rather than with a steady partner. IV drug use by the
partner was not a predictor of condom use.

Weatherburn, Peter; Davies, Peter M.; Hickson, Ford C. I.; Hunt,
Andrew J.; and others.
      No connection between alcohol use and unsafe sex among gay
and bisexual men. AIDS, 1993 Jan, v7 (n1):115-119.

Abstract: 461 gay and bisexual males were interviewed as part of
Project SIGMA (Socio-sexual Investigations of Gay Men and AIDS),
a 6-yr study of homosexual men in England and Wales. During the
interview, retrospective diary data for the preceding week were
collected regarding alcohol use, quantity of alcohol consumed, and
sexual behaviors including partner, sequence and type of sexual
acts, and condom use. No statistically distinguishable differences
were found in HIV risk behaviors between sexual sessions that took
place under the influence of alcohol and those that did not.
Subjects were no more likely to engage in risky sexual behaviors
after consuming alcohol than otherwise and, for those who did have
sex while under the influence of alcohol, the quantity of alcohol
consumed had no effect on risk behavior.

White, D. G.; Phillips, K.; Mulleady, G.; Cupitt, C.
      Sexual issues and condom use among injecting drug users. AIDS
Care, 1993, v5 (n4):427-437.

Abstract: Assessed the behaviors and attitudes of 141 predominantly
heterosexual, injecting drug users to sexual issues, including
condom use. Information was gathered using a structured, in-depth
interview. The majority of Subjects were polydrug users and were
injecting opiates/benzodiazepines. 20 Subjects were reportedly HIV
positive. Condom use was low. Obstacles to their use included a
desire to conceive, a belief in their infertility, a perceived
invulnerability to HIV infection through their sexual behavior
patterns, a dislike of condoms, and difficulty in negotiating
condom use with partners. The lifestyle of drug users may also have
had an influence on condom use: Many drug users funded their habit
through illegal activities including prostitution, theft, and
fraud. The association between these and other factors and condom
use is explored.

Wingood, Gina M.; Hunter-Gamble, Dinese; DiClemente, Ralph J.
      A pilot study of sexual communication and negotiation among
young African American women: Implications for HIV prevention.
Special Issue: Psychosocial aspects of AIDS prevention among
African Americans. Journal of Black Psychology, 1993 May, v19
(n2):190-203.

Abstract: Conducted focus groups with 18 low-income African-
American women (aged 18-25 yrs) to explore the process of sexual
communication and barriers toward sexual negotiation of condom use.
Findings suggest that HIV prevention programs tailored to  
African-American women should emphasize training in sexual
negotiation, conflict resolution, and refusal skills.

Yep, Gust A.
      Health beliefs and HIV prevention: Do they predict monogamy
and condom use? Journal of Social Behavior & Personality, 1993, v8
(n3):507-520.

Abstract: Tested 4 health beliefs (perceived susceptibility,
severity, benefits, and barrier), as postulated by the health
belief model, in terms of their capacity to predict sexual
monogamy, condom use, and overall changes in health behavior in
the context of HIV prevention. 153 undergraduates who had been
sexually active in the previous 6 mo completed surveys. Findings
indicate that perceived susceptibility and barriers were
significant predictors of the adoption of certain HIV-preventive
behaviors among Subjects. In particular, susceptibility was a
significant predictor of monogamy, while barrier significantly
predicted monogamy and overall changes in health behavior.
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