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Selterman D, Joel S, Dale V. No Remorse: Sexual Infidelity Is Not Clearly Linked with Relationship Satisfaction or Well-Being in Ashley Madison Users. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2561-2573. [PMID: 37010618 PMCID: PMC10069361 DOI: 10.1007/s10508-023-02573-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/01/2023] [Accepted: 02/22/2023] [Indexed: 05/04/2023]
Abstract
Past research on extradyadic relationship experiences (including infidelity) often suffers from restricted sampling and retrospective accounts, which may have given researchers a distorted image of what it is like for people to have affairs. In this research, we shed light on the experiences people have during their affairs with a sample of registered users on Ashley Madison, a website geared toward facilitating infidelity. Our participants completed questionnaires about their primary (e.g., spousal) relationships, as well as personality traits, motivations to seek affairs, and outcomes. Findings from this study challenge widely held notions about infidelity experiences. Analyses revealed that participants were highly satisfied with their affairs and expressed little moral regret. A small subset of participants reported having consensually open relationships with their partners, who knew about their activity on Ashley Madison. In contrast to previous findings, we did not observe low relationship quality (i.e., satisfaction, love, commitment) to be a major driver of affairs and the affairs did not predict decreases in these relationship quality variables over time. That is, among a sample of individuals who proactively sought affairs, their affairs were not primarily motivated by poor dyadic/marital relationships, their affairs did not seem to have a strong negative impact on their relationships, and personal ethics did not play a strong role in people's feelings about their affairs.
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Affiliation(s)
- Dylan Selterman
- Department of Psychological & Brain Sciences, Johns Hopkins University, 3400 N. Charles Street, Baltimore, MD, 21218, USA.
| | - Samantha Joel
- Department of Psychology, University of Western Ontario, London, ON, Canada
| | - Victoria Dale
- Department of Psychology, University of Western Ontario, London, ON, Canada
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2
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Conley TD, Piemonte JL, Shukla I, Mangla A, Mateti N, Tariq S. Monogamy as protection against COVID-19?: Non-monogamy stigma and risk (Mis)perception. ANALYSES OF SOCIAL ISSUES AND PUBLIC POLICY : ASAP 2022; 22:ASAP12325. [PMID: 36246084 PMCID: PMC9538616 DOI: 10.1111/asap.12325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 06/16/2023]
Abstract
COVID-19 public health messages largely communicated that Americans were "safer at home." Implicit in this advice are messages about protections ostensibly also offered by monogamy-that having more relationships is always more dangerous than having fewer relationships and that closer relationships are always safer-from a disease transmission perspective-than unfamiliar relationships. These heuristics may have led people to discount other COVID-19 dangers (such as spending more time with others of unknown infection status) and to ignore COVID-specific safety measures (such as mask-wearing, and ventilation). We conducted three studies in which we used experimental vignettes to assess people's perceptions of COVID-risky targets in monogamous relationships with a close, committed partner versus targets who were described as non-monogamous with casual partners but relatively COVID-safe. Participants perceived monogamous-but-COVID-riskier targets as more responsible and safer from COVID-19. Non-monogamy stigma seems to extend analogously to COVID-19 risk. Public health messages that fail to attend to the specifics and nuances of close relationships risk contributing to this stigma and ultimately undermining the goals of reducing the spread of infectious disease.
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Affiliation(s)
- Terri D. Conley
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | | | - Ishita Shukla
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | - Ananya Mangla
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | - Nainika Mateti
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
| | - Soha Tariq
- Department of PsychologyUniversity of MichiganAnn ArborMichiganUSA
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3
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Thomas JA, Ditchman N, Beedle RB. The impact of knowledge, self-efficacy, and stigma on STI testing intention among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1415-1425. [PMID: 32790582 DOI: 10.1080/07448481.2020.1799808] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 07/16/2020] [Indexed: 06/11/2023]
Abstract
Objective: Young people represent over half of the new cases of sexually transmitted infections (STIs) each year in the United States. This study examined how STI knowledge, self-efficacy, and stigma impact STI testing intention among sexually active college students using path model analysis. Participants: Participants included 76 college students (74.1% undergraduate, Mage = 23.05). Method: Data were collected via online survey. Path analysis was conducted using SPSS AMOS, and MacKinnon's ab product approach in RMediation was used to test mediating effects. Results: The hypothesized path model fit the data well and the relationships between self-efficacy and knowledge, stigma, and STI testing intention were significant. Mediation analysis revealed significant indirect paths for knowledge and stigma on STI testing intention through self-efficacy. Conclusion: Findings suggest that college health providers may be able to increase the frequency of STI testing behavior by promoting strategies to increase students' self-efficacy.
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Affiliation(s)
- J A Thomas
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
| | - N Ditchman
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
| | - R B Beedle
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
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Kelberga A(K, Martinsone B. Differences in Motivation to Engage in Sexual Activity Between People in Monogamous and Non-monogamous Committed Relationships. Front Psychol 2021; 12:753460. [PMID: 34803835 PMCID: PMC8595918 DOI: 10.3389/fpsyg.2021.753460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/04/2021] [Indexed: 12/03/2022] Open
Abstract
This study compared motivations to engage in sex between monogamous and non-monogamous respondents (n = 1,238, out of which 641 monogamous and 596 non-monogamous respondents; women-47.4%, men-50.9%, other gender-1.7%; age: M = 27.78 years, SD = 7.53, range = 18-62). The research aim was to identify whether there are differences in self-reported reasons to engage in sexual activity between these two groups. Presented with 17 reasons to engage in sexual activity, the respondents rated the frequency with which they engage in sex for each reason. While both monogamous and non-monogamous respondents reported to engage in sex with the same frequency for the reasons of sexual release and physical desirability of a partner, the research uncovered that non-monogamous respondents engage in sex significantly more often to seek new experiences, to boost self-esteem, to guard their mate, to have a specific kind of sex (such as anal, kink, or fetish) or to experience the thrill of the forbidden. Non-monogamous respondents reported higher frequency to engage in sex for most reasons overall. The study also revealed that there are differences in reasons to engage in sex among men and women, some of the differences are related to the relationship status (monogamous or non-monogamous), while others are universal for men or women irrespective of their monogamy status.
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McRae LD, Cobb RJ. A qualitative analysis of themes in long-distance couples’ relationship boundary discussions. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2020. [DOI: 10.3138/cjhs.2020-0005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Lauren D. McRae
- Department of Psychology, Simon Fraser University, Burnaby, BC
| | - Rebecca J. Cobb
- Department of Psychology, Simon Fraser University, Burnaby, BC
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6
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Nekoolaltak M, Keshavarz Z, Simbar M, Nazari AM, Baghestani AR. Sexual Compatibility with Spouse Questionnaire: Development and Psychometric Property Evaluation. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2020. [PMID: 32656274 DOI: 10.30476/ijcbnm.2020.82160.1039.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background Sexual compatibility between husband and wife is an effective factor in both sexual and marital satisfaction. However, there is limited valid and reliable questionnaire to measure the degree of sexual compatibility between the couples. Methods In this exploratory mixed method study, 54 individuals were interviewed in the qualitative phase and 448 persons participated in the quantitative phase. Totally 502 participants (261 woman, 241 men) took part in this study. According to 205 final codes derived from the qualitative phase, 102 initial items were developed, the number of which reached 69 items after deletion and merging performed by the research team. After face validity, content validity and construct validity, 68 items were introduced into the construct validity phase. Results Following exploratory factor analysis and promax rotation, the items were reduced to 35 in 4 factors: "Requirements of a sexual relationship", "Sexual agreement", "Contextual obstacles" and "Outcomes of sexual compatibility". The questionnaire Cronbach alpha and correlation coefficient of the test-retest method were 0.90 and 0.91, respectively. Conclusion Final Questionnaire included 35 items in 4 point-Likert scale with total score of between 35-140. This valid and reliable questionnaire is brief, easily interpreted and can measure the main factors affecting sexual compatibility with the spouse in clinics and research fields.
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Affiliation(s)
- Maryam Nekoolaltak
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Keshavarz
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Mohammad Nazari
- Department of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahrood, Iran
| | - Ahmad Reza Baghestani
- Physiotherapy Research Center,Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lee BH, O'Sullivan LF. Walk the Line: How Successful Are Efforts to Maintain Monogamy in Intimate Relationships? ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1735-1748. [PMID: 31214908 PMCID: PMC6669241 DOI: 10.1007/s10508-018-1376-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 10/03/2018] [Accepted: 11/28/2018] [Indexed: 06/09/2023]
Abstract
Monogamy, typically defined as sexual and romantic exclusivity to one partner, is a near-universal expectation in committed intimate relationships in Western societies. Attractive alternative partners are a common threat to monogamous relationships. However, little is known about how individuals strive to protect their relationships from tempting alternatives, particularly those embedded in one's social network. The current exploratory study was guided by the Investment Model, which states that satisfaction, investments, and perceived alternatives to a relationship predict commitment, which in turn predicts relationship longevity. The study aimed to identify relationship and extradyadic attraction characteristics associated with monogamy maintenance efforts, specifically relationship commitment, as predicted by the Investment Model. The efficacy of monogamy maintenance efforts was assessed via sexual and emotional infidelity measures at a 2-month follow-up. U.S. adults in heterosexual intimate relationships (N = 287; 50.2% male; M age = 34.5 years; M relationship length = 87 months) were recruited online to complete the survey study. Through structural equation modelling, the Investment Model structure was replicated, and relationship commitment predicted use of relationship-enhancing efforts as well as self-monitoring/derogation efforts. Individuals who experienced reciprocated attraction used significantly more avoidance and self-monitoring/derogation efforts than did those who experienced unreciprocated attraction. Ultimately, monogamy maintenance efforts did not significantly predict success in maintaining monogamy at follow-up. These findings have important research, educational, and clinical implications relating to relationship longevity.
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Affiliation(s)
- Brenda H Lee
- Department of Psychology, University of New Brunswick, Fredericton, NB, E3B5A3, Canada.
| | - Lucia F O'Sullivan
- Department of Psychology, University of New Brunswick, Fredericton, NB, E3B5A3, Canada
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8
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Thompson EL, Vamos CA, Piepenbrink R, Kadono M, Vázquez-Otero C, Matthes S, Daley EM. Human papillomavirus risk perceptions and relationship status: a barrier to HPV vaccination? J Behav Med 2019; 42:991-997. [PMID: 30879225 DOI: 10.1007/s10865-019-00025-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 03/09/2019] [Indexed: 12/20/2022]
Abstract
The purpose of this study was to assess the association between relationship status and perceived risk for human papillomavirus (HPV) among young adults. College adults, aged 18-26 years, completed an online survey from November 2016-April 2017 (n = 385). The survey assessed HPV vaccination status, perceived HPV risk, and current relationship status. Logistic regression models estimated the odds of perceived high risk for HPV, stratified by vaccination status. Among unvaccinated women, relationship status and HPV risk perception were significantly associated, with dating women more likely (OR = 5.33, 95%CI 1.16-24.50) to perceive a high risk for HPV compared to women in a committed relationship. Women in relationships were less likely to perceive themselves at high risk for HPV, even though HPV infection is prevalent among young adults. This association is not present for vaccinated women, suggesting that relationship status and risk perceptions may represent barriers to HPV vaccine uptake.
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Affiliation(s)
- Erika L Thompson
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA.
| | - Cheryl A Vamos
- Community and Family Health Concentration, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 32612, USA
| | - Rumour Piepenbrink
- Community and Family Health Concentration, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 32612, USA
| | - Mika Kadono
- Community and Family Health Concentration, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 32612, USA
- Department of Anthropology, College of Arts and Sciences, University of South Florida, 4202 East Fowler Ave SOC107, Tampa, FL, 33620, USA
| | - Coralia Vázquez-Otero
- Community and Family Health Concentration, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 32612, USA
| | - Sarah Matthes
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
| | - Ellen M Daley
- Community and Family Health Concentration, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL, 32612, USA
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9
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Abstract
A sexual agreement is a mutual understanding between two partners regarding sexual and relational behaviors both within and outside of their relationship. Sexual agreements have been central to research and programming efforts around HIV prevention, primarily for male couples. A comprehensive scoping review of the primary literature on sexual agreements, including negotiated safety, was performed to identify what is known about sexual agreements among couples (n = 66). Results indicate a wide range of prevalence of agreements and measurements used to characterize sexual agreements. Findings also report associations between sexual agreements and health and relational outcomes. Several knowledge gaps were identified; specifically, the need to expand sexual agreements research beyond MSM populations and the need to better understand agreement breaks, break disclosure, and how variation in agreement categorization may impact reported prevalence. This review demonstrates the importance of broadening the evidence-base of sexual agreements research and programmatic focus.
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10
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Marie Harvey S, Oakley LP, Washburn I, Agnew CR. Contraceptive Method Choice Among Young Adults: Influence of Individual and Relationship Factors. JOURNAL OF SEX RESEARCH 2018; 55:1106-1115. [PMID: 29373039 PMCID: PMC6105557 DOI: 10.1080/00224499.2017.1419334] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Because decisions related to contraceptive behavior are often made by young adults in the context of specific relationships, the relational context likely influences use of contraceptives. Data presented here are from in-person structured interviews with 536 Black, Hispanic, and White young adults from East Los Angeles, California. We collected partner-specific relational and contraceptive data on all sexual partnerships for each individual, on four occasions, over one year. Using three-level multinomial logistic regression models, we examined individual and relationship factors predictive of contraceptive use. Results indicated that both individual and relationship factors predicted contraceptive use, but factors varied by method. Participants reporting greater perceived partner exclusivity and relationship commitment were more likely to use hormonal/long-acting methods only or a less effective method/no method versus condoms only. Those with greater participation in sexual decision making were more likely to use any method over a less effective method/no method and were more likely to use condoms only or dual methods versus a hormonal/long-acting method only. In addition, for women only, those who reported greater relationship commitment were more likely to use hormonal/long-acting methods or a less effective method/no method versus a dual method. In summary, interactive relationship qualities and dynamics (commitment and sexual decision making) significantly predicted contraceptive use.
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Affiliation(s)
- S. Marie Harvey
- Associate Dean for Research and Graduate Programs, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR
| | - Lisa P. Oakley
- Postdoc-Research Associate, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR
| | - Isaac Washburn
- Assistant Professor, Human Development and Family Science, Oklahoma State University, Stillwater, OK
| | - Christopher R. Agnew
- Professor and Head of Department, Psychological Sciences, Purdue University, Lafayette, IN
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Tannebaum M. College students' use of technology to communicate with romantic partners about sexual health issues. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2018; 66:393-400. [PMID: 29447621 DOI: 10.1080/07448481.2018.1440585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To examine college students' technology-assisted sexual communication perceptions and practices alongside their beliefs about the effectiveness of face-to-face (F-t-F) sexual communication. PARTICIPANTS 144 college students at a private university in the Northeast, U.S., completed a survey in October 2016. METHOD A cross-sectional online survey examined how college students use text messaging and private social media messaging to communicate with romantic partners about sexual health issues. RESULTS Students who have communicated with romantic partners via technology reported being likely to do so again in the future, to perceive the effectiveness of technology-assisted sexual communication to be comparable to F-t-F sexual communication, and to be confident in their ability to initiate sexual communication with romantic partners via F-t-F communication. CONCLUSIONS College students may see text messaging and social media messaging as useful for sexual communication, which has important implications for college health professionals who wish to promote frequent, effective sexual communication.
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Affiliation(s)
- Michael Tannebaum
- a Northeastern University , 360 Huntington Avenue, Boston , Massachusetts , USA
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12
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Lee JY, Mitchell JW. Expanding Couples-Based HIV Testing and Counseling in the United States: Findings from a Nationwide, Online Survey of Partnered Adults. J Assoc Nurses AIDS Care 2018; 29:728-736. [PMID: 29784522 DOI: 10.1016/j.jana.2018.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 04/13/2018] [Indexed: 10/17/2022]
Abstract
Couples-based HIV testing and counseling (CHTC) is currently available only for gay male couples in the United States, but other types of couples could benefit from this service. Our cross-sectional, online study collected data from 536 partnered adults to assess interest in using CHTC and associated factors. Adjusted odds ratios were calculated with ordinal logistic regression to analyze factors associated with greater interest in using CHTC. Most participants were female, White, non-Hispanic, and/or students who were dating exclusively and sexually active. Participant interest in using CHTC varied. Greater interest was associated with identifying as bisexual or questioning (adjusted odds ratio [aOR] 2.53, p < .05); having a sexual agreement (aOR 6.82, p < .001); and inconsistent or no condom use for anal sex (aOR 0.31, p < .05). These findings lend support for additional research about how best to extend and offer CHTC to a wider variety of couples.
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Nekoolaltak M, Keshavarz Z, Simbar M, Nazari AM, Baghestani AR. Sexual compatibility among Iranian couples: a qualitative study. SEXUAL AND RELATIONSHIP THERAPY 2017. [DOI: 10.1080/14681994.2017.1347615] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Maryam Nekoolaltak
- Department of midwifery and reproductive health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Keshavarz
- Department of midwifery and reproductive health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Ali Mohammad Nazari
- Department of Nursing and Midwifery, Shahrood University of Medical Science, Shahrood, Iran
| | - Ahmad Reza Baghestani
- Department of Biostatistics, School of Allied Medical science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Harvey SM, Washburn I, Oakley L, Warren J, Sanchez D. Competing Priorities: Partner-Specific Relationship Characteristics and Motives for Condom Use Among At-Risk Young Adults. JOURNAL OF SEX RESEARCH 2017; 54:665-676. [PMID: 27246878 DOI: 10.1080/00224499.2016.1182961] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Condoms protect against human immunodeficiency virus (HIV)/sexually transmitted infections (STIs) and unintended pregnancy and are essential to sexual health efforts targeting young adults, who are disproportionately affected by both outcomes. Understanding condom use motives is critical to increasing condom use. Research in this area is limited, particularly regarding the roles of partners and relationship factors. Using a longitudinal sample of 441 young adults and 684 reported partnerships we examined associations between relationship factors and condom use motives (pregnancy prevention, disease prevention, or dual protection). Simultaneous multilevel models identified variables associated with motives; level-specific models identified the levels (individual, partnership, time) variables impacted motives. Participants reported choosing condoms for pregnancy prevention, disease prevention, and dual protection in 51%, 17%, and 33% of partnerships, respectively. Partner-specific factors varied, to a differing degree, across the three levels. Seven variables (duration, condom self-efficacy, commitment, sexual decision-making, power, and vulnerability to harm [HIV/STIs] and pregnancy) distinguished condom use motives. The level of this association varied but was most pronounced at the partner and individual levels. Researchers and practitioners should consider the impact of both individual- and partner-level factors on condom use motives, in both research and sexual health programs.
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Affiliation(s)
- S Marie Harvey
- a College of Public Health and Human Sciences , Oregon State University
| | - Isaac Washburn
- b Human Development and Family Science , Oklahoma State University
| | - Lisa Oakley
- a College of Public Health and Human Sciences , Oregon State University
| | - Jocelyn Warren
- c Public Health Manager , Lane County Health and Human Services
| | - Diana Sanchez
- d Department of Epidemiology , Gillings School of Global Public Health
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15
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Mitchell JW, Gamarel KE. Constructive communication patterns and associated factors among male couples. JOURNAL OF COUPLE & RELATIONSHIP THERAPY 2017; 17:79-96. [PMID: 30906232 PMCID: PMC6426336 DOI: 10.1080/15332691.2017.1302378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Constructive communication is an important correlate to examine for sexual health promotion and HIV prevention among male couples. However, few studies have examined the effect of different relationship dynamics on both partners' perceptions of constructive communication. Using dyadic data collected from 361 male couples, the present study explores which relationship dynamics were associated with constructive communication patterns. The results highlight the relevance of investment in a sexual agreement and trust within the relationship in perceptions of constructive communication. These findings may be particularly useful to guide the development of future dyadic-focused sexual health and HIV preventive interventions for male couples.
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Affiliation(s)
| | - Kristi E. Gamarel
- Department of Behavioral and Social Sciences, Brown University School of Public Health
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
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16
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Agnew CR, Harvey SM, VanderDrift LE, Warren J. Relational underpinnings of condom use: Findings from the project on partner dynamics. Health Psychol 2017; 36:713-720. [PMID: 28277704 DOI: 10.1037/hea0000488] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine how relational qualities, including commitment to a sexual partner, are associated with condom use among young heterosexual adults at increased risk for sexually transmitted infections. Guided by the investment model of commitment processes, we hypothesized that sexual partner commitment is a function of satisfaction with, alternatives to, and investments in the relationship. Commitment to a sexual partner is, in turn, associated with reduced perceptions of vulnerability to sexually transmitted infection acquisition, which results in lowered condom use intentions and use. METHOD We tested the hypothesized model using data from the Project on Partner Dynamics (POPD), a 4-wave, 1-year longitudinal study featuring a Time 1 sample of 538 African American, Hispanic, and White young adult from East Los Angeles, California, who provided data on all their sexual relationships over the year. RESULTS Findings from hierarchical path models supported the hypotheses, with relational qualities significantly linked to condom use via commitment, perceived vulnerability to harm from partner and intentions to use. CONCLUSION These findings have implications for improving the health of high-risk individuals, including suggesting the importance of raising awareness of relational qualities that may give rise to unsafe sexual practices. (PsycINFO Database Record
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17
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Leblanc NM, Mitchell JW, De Santis JP. Negotiated safety - components, context and use: an integrative literature review. J Adv Nurs 2017; 73:1583-1603. [PMID: 27906471 DOI: 10.1111/jan.13228] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2016] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to examine the components and use of negotiated safety in the context of HIV prevention and to identify reported factors associated with the concept. BACKGROUND There is an emerging interest in dyadic approaches to address HIV transmission. Although there are theoretical foundations for how interpersonal relationships influence individual behaviour, how these dyadic processes influence on health is still not wholly understood. DESIGN Integrative review of empirical and theoretical literature. DATA SOURCES The Cumulative Index for Nursing and Allied Health Literature (CINAHL) MEDLINE and PsychINFO electronic databases were accessed. REVIEW METHODS Articles were read to gain a historical context of the term and identify varying interpretations of the concept. Factors warranting consideration in association with NS were identified and clinical and public health implications were noted. RESULTS Forty-eight studies were reviewed. Negotiated safety included the following components: (i) HIV sero-negative concordant men within a primary relationship; (ii) joint HIV screening and mutual disclosure of their HIV status; (iii) explicit relationship boundaries which establish either nonexclusively that allows for the dispensing of condoms within the primary relationship and consistent condom use for extra-dyadic sex; or dispensing of condoms within a primary partnership and exclusivity; and (iv) a breach clause that allows communication to re-establish the agreement if needed. CONCLUSION Negotiated safety is a prescriptive approach to HIV risk reduction among couples. Researchers and practitioners could benefit from promoting this approach to HIV prevention.
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Affiliation(s)
- Natalie M Leblanc
- School of Nursing and Health Sciences, University of Miami, Florida, USA
| | - Jason W Mitchell
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Joseph P De Santis
- Graduate Programs, School of Nursing and Health Sciences, University of Miami, Florida, USA
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Thompson AE, O'Sullivan LF. Drawing the Line: The Development of a Comprehensive Assessment of Infidelity Judgments. JOURNAL OF SEX RESEARCH 2016; 53:910-926. [PMID: 26580975 DOI: 10.1080/00224499.2015.1062840] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Infidelity is a leading cause of relationship discord and dissolution, and couples generally report expectations to maintain monogamy. However, a majority of men and women report engaging in some form of infidelity at least once in their lives. Research assessing judgments of the behaviors that constitute infidelity is lacking. The three studies reported here advanced the literature by developing and validating the Definitions of Infidelity Questionnaire (DIQ), a comprehensive measure examining infidelity judgments. Exploratory and confirmatory factor analyses indicated four factors to the scale: sexual/explicit behaviors, technology/online behaviors, emotional/affectionate behaviors, and solitary behaviors. Investigation of the psychometric properties demonstrated the DIQ to be reliable and valid. Participants agreed that sexual/explicit behaviors comprised infidelity to the largest extent, whereas other types of behaviors (technology/online behaviors, emotional/affectionate behaviors, and solitary behaviors) were judged as comprising infidelity to a lesser extent. Men reported more permissive judgments than did women. This study provides insights regarding operationalizing infidelity and identifying areas of ambiguity and consensus. Implications of the findings for educators and practitioners working with individuals in intimate relationships are discussed.
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19
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Abstract
The majority of HIV prevention studies and programs have targeted individuals or operated at the community level. This has also been the standard approach when incorporating technology (e.g., web-based, smartphones) to help improve HIV prevention efforts. The tides have turned for both approaches: greater attention is now focusing on couple-based HIV prevention and using technology to help improve these efforts for maximizing reach and potential impact. To assess the extent that technology has been used to help advance HIV prevention with couples, a literature review was conducted using four databases and included studies that collected data from 2000 to early 2015. Results from this review suggest that technology has primarily been used to help advance HIV prevention with couples as a tool for (1) recruitment and data collection and (2) intervention development. Challenges and limitations of conducting research (e.g., validity of dyadic data) along with future directions for how technology (e.g., mHealth, wearable sensors) can be used to advance HIV prevention with couples are then discussed. Given the growing and near ubiquitous use of the Internet and smartphones, further efforts in the realm of mHealth (e.g., applications or "apps") and eHealth are needed to develop novel couple-focused HIV-preventive interventions.
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Affiliation(s)
- Jason W Mitchell
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1021, Miami, FL, 33136, USA.
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20
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Currin JM, Hubach RD, Brown C, Farley S. Impact of non-heterosexual impulses on heterosexuals’ attitudes towards monogamy and casual sex. PSYCHOLOGY & SEXUALITY 2016. [DOI: 10.1080/19419899.2016.1168313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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van Eeden-Moorefield B, Malloy K, Benson K. Gay Men’s (Non)Monogamy Ideals and Lived Experience. SEX ROLES 2015. [DOI: 10.1007/s11199-015-0566-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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22
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Hotton AL, French AL, Hosek SG, Kendrick SR, Lemos D, Brothers J, Kincaid SL, Mehta SD. Relationship Dynamics and Sexual Risk Reduction Strategies Among Heterosexual Young Adults: A Qualitative Study of Sexually Transmitted Infection Clinic Attendees at an Urban Chicago Health Center. AIDS Patient Care STDS 2015; 29:668-74. [PMID: 26588197 DOI: 10.1089/apc.2015.0146] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Few studies have examined risk-reduction alternatives to consistent condom use for HIV prevention among heterosexual young adults. We used qualitative methodology to explore risk reduction strategies and contextual factors influencing attempts to reduce risk in an urban, high morbidity sexually transmitted infection (STI) clinic. Focus groups were conducted October-December 2014 with heterosexually identified men (n = 13) and women (n = 20) aged 18-29 seeking STI screening at an urban clinic. Groups were audio recorded, transcribed verbatim, and analyzed for thematic content using Atlas.ti software. Quantitative information included sociodemographics, HIV/STI testing history, and 6-month sexual behaviors. Among 33 predominantly African-American participants with a median age of 22, risk-reduction strategies included monogamy agreements, selective condom use with casual and high-risk partners, and frequent HIV/STI testing, though testing was commonly used as a post-hoc reassurance after risk exposure. Many men and women used implicit risk assessment strategies due to mistrust or difficulty communicating. Concurrency was common but rarely discussed within partnerships. Despite attempts to reduce risk, monogamy agreements were often poorly adhered to and not openly discussed. Alcohol and substance use frequently interfered with safer sexual decisions. Participants were aware of HIV/STI risk and commonly practiced risk-reduction strategies, but acknowledged faulty assumptions and poor adherence. This work provides insights into risk-reduction approaches that are already used and may be strengthened as part of effective HIV/STI prevention interventions.
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Affiliation(s)
- Anna L. Hotton
- Department of Medicine, CORE Center/John Stroger Hospital of Cook County, Chicago, Illinois
- Department of Epidemiology and Biostatistics, University of Illinois Chicago School of Public Health, Chicago, Illinois
| | - Audrey L. French
- Department of Medicine, CORE Center/John Stroger Hospital of Cook County, Chicago, Illinois
- Rush University Medical Center, Chicago, Illinois
| | - Sybil G. Hosek
- Department of Psychiatry, CORE Center/John Stroger Hospital of Cook County, Chicago, Illinois
| | - Sabrina R. Kendrick
- Department of Medicine, CORE Center/John Stroger Hospital of Cook County, Chicago, Illinois
- Rush University Medical Center, Chicago, Illinois
| | - Diana Lemos
- Department of Psychiatry, CORE Center/John Stroger Hospital of Cook County, Chicago, Illinois
| | - Jennifer Brothers
- Department of Psychiatry, CORE Center/John Stroger Hospital of Cook County, Chicago, Illinois
| | - Stacey L. Kincaid
- Department of Medicine, CORE Center/John Stroger Hospital of Cook County, Chicago, Illinois
| | - Supriya D. Mehta
- Department of Epidemiology and Biostatistics, University of Illinois Chicago School of Public Health, Chicago, Illinois
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23
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Kottke M, Whiteman MK, Kraft JM, Goedken P, Wiener J, Kourtis AP, DiClemente R. Use of Dual Methods for Protection from Unintended Pregnancy and Sexually Transmitted Diseases in Adolescent African American Women. J Pediatr Adolesc Gynecol 2015; 28:543-8. [PMID: 26152648 PMCID: PMC4618263 DOI: 10.1016/j.jpag.2015.04.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Revised: 03/19/2015] [Accepted: 04/14/2015] [Indexed: 11/25/2022]
Abstract
STUDY OBJECTIVE To characterize factors associated with dual method contraceptive use in a sample of adolescent women. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We conducted a cross-sectional survey of sexually active African American women aged 14-19 years who attended an urban Title X clinic in Georgia in 2012 (N = 350). Participants completed a computerized survey to assess contraceptive and condom use during the past 2 sexual encounters with their most recent partner. Dual method use was defined as use of a hormonal contraceptive or intrauterine device and a condom. We applied multinomial logistic regression, using generalized estimating equations, to examine the adjusted association between dual method use (vs use of no methods or less effective methods alone; eg, withdrawal) and select characteristics. RESULTS Dual methods were used by 20.6% of participants at last sexual intercourse and 23.6% at next to last sexual intercourse. Having a previous sexually transmitted disease (adjusted odds ratio [aOR], 2.30; 95% confidence interval [CI], 1.26-4.18), negative attitude toward pregnancy (aOR, 2.25; 95% CI, 1.19-4.28), and a mother who gave birth as a teen (aOR, 2.34; 95% CI, 1.21-4.52) were associated with higher odds of dual method use. Having no health insurance (aOR, 0.39; 95% CI, 0.18-0.82), 4 or more lifetime sexual partners (aOR, 0.42; 95% CI, 0.22-0.78), sex at least weekly (aOR, 0.54; 95% CI, 0.29-0.99), and agreeing to monogamy with the most recent partner (aOR, 0.40; 95% CI, 0.16-0.96) were associated with decreased odds of dual method use. CONCLUSION Dual method use was uncommon in our sample. Efforts to increase use of dual methods should address individual and relationship factors.
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Affiliation(s)
- Melissa Kottke
- Department of Gynecology and Obstetrics, Emory University, School of Medicine, Atlanta, Georgia.
| | - Maura K Whiteman
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joan Marie Kraft
- Department of Behavioral Science and Health Education, Emory University, Rollins School of Public Health, Atlanta, Georgia
| | - Peggy Goedken
- Department of Gynecology and Obstetrics, Emory University, School of Medicine, Atlanta, Georgia
| | - Jeffrey Wiener
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Athena P Kourtis
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ralph DiClemente
- Department of Behavioral Science and Health Education, Emory University, Rollins School of Public Health, Atlanta, Georgia
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24
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Sanchez DM, Schoenbach VJ, Harvey SM, Warren JT, Adimora AA, Poole C, Leone PA, Agnew CR. Association of perceived partner non-monogamy with prevalent and incident sexual concurrency. Sex Transm Infect 2015; 92:266-71. [PMID: 26574570 DOI: 10.1136/sextrans-2015-052111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 10/17/2015] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Concurrency is suggested as an important factor in sexually transmitted infection transmission and acquisition, though little is known regarding factors that may predict concurrency initiation. We examined the association between perception of a partner's non-monogamy (PPNM) and simultaneous or subsequent concurrency among at-risk heterosexual young adults in the Los Angeles area. METHODS We used Poisson regression models to estimate the relationship between PPNM and incident concurrency among 536 participants participating in a cohort study, interviewed at 4-month periods during 1 year. Concurrency was defined as an overlap in reported sexual partnership dates; PPNM was defined as believing a partner was also having sex with someone else. RESULTS Participants (51% female; 30% non-Hispanic white, 28% non-Hispanic black, 27% Hispanic/Latino) had a mean age of 23 years and lifetime median of nine sex partners. At each interview (baseline, 4-month, 8-month and 12-month), 4-month concurrency prevalence was, respectively, 38.8%, 27.4%, 23.1% and 24.5%. Four-month concurrency incidence at 4, 8 and 12 months was 8.5%, 10.6% and 17.8%, respectively. Participants with recent PPNM were more likely to initiate concurrency (crude 4-month RR=4.6; 95% CI 3.0, 7.0; adjusted 4-month RR=4.0, 95% CI 2.6 to 6.1). CONCLUSIONS Recent PPNM was associated with incident concurrency. Among young adults, onset of concurrency may be stimulated, relatively quickly, by the PPNM. Programmes which promote relationship communication skills and explicit monogamy expectations may help reduce concurrency.
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Affiliation(s)
- Diana M Sanchez
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Victor J Schoenbach
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - S Marie Harvey
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Jocelyn T Warren
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Adaora A Adimora
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Charles Poole
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Peter A Leone
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Christopher R Agnew
- Department of Psychological Sciences, Purdue University, West Lafayette, Indiana, USA
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25
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Swan DJ, Thompson SC. Monogamy, the Protective Fallacy: Sexual versus Emotional Exclusivity and the Implication for Sexual Health Risk. JOURNAL OF SEX RESEARCH 2015; 53:64-73. [PMID: 26169361 DOI: 10.1080/00224499.2014.1003771] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The authors examined the hypothesis that many individuals define monogamy based on emotional rather than sexual fidelity. Participants, 373 heterosexual college students and 282 gay men, read three vignettes of decreasing mitigation in which they imagined committing an act of infidelity against a hypothetical partner and where half the participants were cued to their emotional attachment toward the partner. Despite the infidelity, relationships in the emotional attachment-cued vignettes were rated as monogamous to a greater degree than relationships in the vignettes where emotional attachment was not cued. In addition, over one-third of the participants in our study reported infidelity in their current self-defined monogamous relationships yet also reported feeling more protected from sexual health risks and reported less condom use than individuals who defined their relationship as nonmonogamous. The implications for monogamy as a protective fallacy are discussed.
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Affiliation(s)
- D Joye Swan
- a School of Behavioral and Organizational Sciences , Claremont Graduate University
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26
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Schwartz SJ, Hardy SA, Zamboanga BL, Meca A, Waterman AS, Picariello S, Luyckx K, Crocetti E, Kim SY, Brittian AS, Roberts SE, Whitbourne SK, Ritchie RA, Brown EJ, Forthun LF. Identity in young adulthood: Links with mental health and risky behavior. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2015; 36:39-52. [PMID: 34334855 PMCID: PMC8319849 DOI: 10.1016/j.appdev.2014.10.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The present study was conducted to contribute to our understanding of young adult identity development by deriving latent profiles from intrapersonal and interpersonal indices of identity synthesis and confusion. A sample of 9737 college-attending young adults completed measures of identity, mental health, and health risk behaviors. Four latent profiles emerged: Synthesized (high synthesis, low confusion), Diffused (moderate synthesis, high confusion), Elevated (high synthesis and confusion), and Moderate (moderate synthesis and confusion). The Synthesized profile was associated with the highest well-being and the lowest levels of internalizing, externalizing, and health risks. The Diffused and Elevated profiles were both associated with low well-being and with high internalizing, externalizing, and risky behaviors - with the Elevated profile highest on all of the negative outcomes. The Moderate profile scored intermediately on well-being, internalizing, externalizing, and health risks. These results are discussed in terms of the role of identity within a successful transition to adulthood.
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27
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Jones JS, Stephenson R, Wall KM, Sullivan PS. Relationship Agreements and Willingness to Participate in Couples HIV Testing and Counseling Among Heterosexuals in the U.S. Open AIDS J 2014; 8:50-7. [PMID: 25553143 PMCID: PMC4279034 DOI: 10.2174/1874613601408010050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 11/11/2014] [Accepted: 11/13/2014] [Indexed: 11/22/2022] Open
Abstract
Couples HIV testing and counseling (CHTC) has been used for more than 20 years in African settings and more recently among men who have sex with men in the United States, but little is known about willingness of heterosexuals in the U.S. to use CHTC. We conducted an online survey of heterosexuals in sexual relationships to assess willingness to use CHTC and willingness to discuss relationship agreements within a couples counseling session. We found moderate levels of willingness to use CHTC and somewhat higher levels of willingness to discuss relationship agreements in a couples counseling session. The most frequently cited reason people were not willing was that they did not perceive themselves or their partners to be at risk for HIV. These results will be useful in planning for CHTC implementation for heterosexuals in the U.S.
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Affiliation(s)
- Jeb S Jones
- Department of Epidemiology, Emory University, USA
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28
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Perceived Level of Relationship Commitment, Sexual Risk Taking and Condom Use Among American Indian Men. J Immigr Minor Health 2014; 17:1078-85. [DOI: 10.1007/s10903-014-0058-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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29
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Van Eck K, Flory K, Willis D. Does distress intolerance moderate the link between ADHD symptoms and number of sexual partners? ACTA ACUST UNITED AC 2014; 7:39-47. [DOI: 10.1007/s12402-014-0140-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 05/14/2014] [Indexed: 11/29/2022]
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Vamos S, Cook R, Chitalu N, Mumbi M, Weiss SM, Jones D. Quality of relationship and sexual risk behaviors among HIV couples in Lusaka, Zambia. AIDS Care 2013; 25:1102-8. [PMID: 23336258 PMCID: PMC3636183 DOI: 10.1080/09540121.2012.749339] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Relationship quality and partner dynamics provide important insights into understanding sexual behavior within HIV sero-positive and sero-discordant couples. Individuals in long-term partnerships may be vulnerable to HIV/sexually transmitted infections (STI) within their relationships due to misperceptions of their partners risk behaviors and potential concurrent (e.g., extramarital, nonprimary) sexual partnerships. This study sought to examine relationship quality among HIV sero-positive and sero-discordant couples in Zambia, and its association with safer sex behavior. This study utilized data drawn from an ongoing translational study, The Partnership II Project - a couples-based sexual risk reduction intervention in Lusaka, Zambia. Couples (n=240) were assessed on demographics, relationship quality, and sexual risk behavior. Overall, couples perceiving their relationships more positively engaged in less risky sexual behavior (i.e., more condom use (b=0.011, t=3.14, p=0.002) and fewer partners (χ(2)=11.4, p=0.003). Within the dyad, condom use was "actor driven," indicating that the association between relationship quality and condom use did not depend on the partner's evaluation of the relationship. Safer sex behavior was positively influenced by communication about condoms. Results support the paradigm shift from prevention strategies with HIV-positive and at-risk individuals to concentrated efforts addressing male-female dyads, and suggest that interventions to address the role of couples' relationship quality, a modifiable target for decreasing sexual risk behavior, are needed.
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Affiliation(s)
- Szonja Vamos
- University of Miami Miller School of Medicine, Dept. of Psychiatry and Behavioral Sciences, Miami, USA
| | - Ryan Cook
- University of Miami Miller School of Medicine, Dept. of Psychiatry and Behavioral Sciences, Miami, USA
| | - Ndashi Chitalu
- University of Zambia, University Teaching Hosptial, Lusaka, Zambia
| | - Miriam Mumbi
- University of Zambia, University Teaching Hosptial, Lusaka, Zambia
| | - Stephen M. Weiss
- University of Miami Miller School of Medicine, Dept. of Psychiatry and Behavioral Sciences, Miami, USA
| | - Deborah Jones
- University of Miami Miller School of Medicine, Dept. of Psychiatry and Behavioral Sciences, Miami, USA
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Bull SS, Levine DK, Black SR, Schmiege SJ, Santelli J. Social media-delivered sexual health intervention: a cluster randomized controlled trial. Am J Prev Med 2012; 43:467-74. [PMID: 23079168 PMCID: PMC3479665 DOI: 10.1016/j.amepre.2012.07.022] [Citation(s) in RCA: 220] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 04/30/2012] [Accepted: 07/03/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Youth are using social media regularly and represent a group facing substantial risk for sexually transmitted infection (STI). Although there is evidence that the Internet can be used effectively in supporting healthy sexual behavior, this has not yet extended to social networking sites. PURPOSE To determine whether STI prevention messages delivered via Facebook are efficacious in preventing increases in sexual risk behavior at 2 and 6 months. DESIGN Cluster RCT, October 2010-May 2011. SETTING/PARTICIPANTS Individuals (seeds) recruited in multiple settings (online, via newspaper ads and face-to-face) were asked to recruit three friends, who in turn recruited additional friends, extending three waves from the seed. Seeds and waves of friends were considered networks and exposed to either the intervention or control condition. INTERVENTION Exposure to Just/Us, a Facebook page developed with youth input, or to control content on 18-24 News, a Facebook page with current events for 2 months. MAIN OUTCOME MEASURES Condom use at last sex and proportion of sex acts protected by condoms. Repeated measures of nested data were used to model main effects of exposure to Just/Us and time by treatment interaction. RESULTS A total of 1578 participants enrolled, with 14% Latino and 35% African-American; 75% of participants completed at least one study follow-up. Time by treatment effects were observed at 2 months for condom use (intervention 68% vs control 56%, p=0.04) and proportion of sex acts protected by condoms (intervention 63% vs control 57%, p=0.03) where intervention participation reduced the tendency for condom use to decrease over time. No effects were seen at 6 months. CONCLUSIONS Social networking sites may be venues for efficacious health education interventions. More work is needed to understand what elements of social media are compelling, how network membership influences effects, and whether linking social media to clinical and social services can be beneficial. TRIAL REGISTRATION This study is registered at www.clinicaltrials.govNCT00725959.
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Affiliation(s)
- Sheana S Bull
- Department of Community and Behavioral Health, Colorado School of Public Health, Denver, Colorado, USA.
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